Marie-Christine Ouellet1, Charles M Morin. 1. Axe de Recherche en Traumatologie et Médecine d'Urgence, Centre de Recherche du Centre Hospitalier Affilié Universitaire de Québec, Québec, QC, Canada. marie-christine.ouellet@mail.mcgill.ca
Abstract
OBJECTIVE: To test the efficacy of a cognitive-behavioral therapy (CBT) for insomnia in persons having sustained traumatic brain injury (TBI). DESIGN: Single-case design with multiple baselines across participants. SETTING: Outpatient rehabilitation center. PARTICIPANTS: Eleven subjects having sustained mild to severe TBI who developed insomnia after the injury. INTERVENTION: Eight-week CBT for insomnia including stimulus control, sleep restriction, cognitive restructuring, sleep hygiene education, and fatigue management. MAIN OUTCOME MEASURES: Total wake time, sleep efficiency, and diagnostic criteria. RESULTS: Visual analyses, corroborated by intervention time series analyses and t tests, revealed clinically and statistically significant reductions in total wake time and sleep efficiency for 8 (73%) of 11 participants. An average reduction of 53.9% in total wake time was observed across participants from pre- to post-treatment. Progress was in general well maintained at the 1-month and 3-month follow-ups. The average sleep efficiency augmented significantly from pretreatment (77.2%) to post-treatment (87.9%), and also by the 3-month follow-up (90.9%). Improvements in sleep were accompanied by a reduction in symptoms of general and physical fatigue. CONCLUSIONS: The results of this study show that psychologic interventions for insomnia are a promising therapeutic avenue for TBI survivors.
OBJECTIVE: To test the efficacy of a cognitive-behavioral therapy (CBT) for insomnia in persons having sustained traumatic brain injury (TBI). DESIGN: Single-case design with multiple baselines across participants. SETTING:Outpatient rehabilitation center. PARTICIPANTS: Eleven subjects having sustained mild to severe TBI who developed insomnia after the injury. INTERVENTION: Eight-week CBT for insomnia including stimulus control, sleep restriction, cognitive restructuring, sleep hygiene education, and fatigue management. MAIN OUTCOME MEASURES: Total wake time, sleep efficiency, and diagnostic criteria. RESULTS: Visual analyses, corroborated by intervention time series analyses and t tests, revealed clinically and statistically significant reductions in total wake time and sleep efficiency for 8 (73%) of 11 participants. An average reduction of 53.9% in total wake time was observed across participants from pre- to post-treatment. Progress was in general well maintained at the 1-month and 3-month follow-ups. The average sleep efficiency augmented significantly from pretreatment (77.2%) to post-treatment (87.9%), and also by the 3-month follow-up (90.9%). Improvements in sleep were accompanied by a reduction in symptoms of general and physical fatigue. CONCLUSIONS: The results of this study show that psychologic interventions for insomnia are a promising therapeutic avenue for TBI survivors.
Authors: Jesse T Fischer; H Julia Hannay; Candice A Alfano; Paul R Swank; Linda Ewing-Cobbs Journal: Neuropsychology Date: 2018-02 Impact factor: 3.295
Authors: Karen A Sullivan; Shannon L Edmed; Alicia C Allan; Lina J E Karlsson; Simon S Smith Journal: J Neurotrauma Date: 2015-02-06 Impact factor: 5.269
Authors: Emerson M Wickwire; David M Schnyer; Anne Germain; Scott G Williams; Christopher J Lettieri; Ashlee B McKeon; Steven M Scharf; Ryan Stocker; Jennifer Albrecht; Neeraj Badjatia; Amy J Markowitz; Geoffrey T Manley Journal: J Neurotrauma Date: 2018-08-24 Impact factor: 5.269
Authors: Emerson M Wickwire; Scott G Williams; Thomas Roth; Vincent F Capaldi; Michael Jaffe; Margaret Moline; Gholam K Motamedi; Gregory W Morgan; Vincent Mysliwiec; Anne Germain; Renee M Pazdan; Reuven Ferziger; Thomas J Balkin; Margaret E MacDonald; Thomas A Macek; Michael R Yochelson; Steven M Scharf; Christopher J Lettieri Journal: Neurotherapeutics Date: 2016-04 Impact factor: 7.620