Abstract
To evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI).
Design
Parallel 2-group randomized controlled trial.
Setting
Outpatient therapy.
Participants
Adults (N=24) with history of TBI and clinically significant sleep and/or fatigue complaints were randomly allocated to an 8-session adapted CBT intervention or a treatment as usual (TAU) condition.
Interventions
Cognitive behavior therapy.
Main Outcome Measures
The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) posttreatment and at 2-month follow-up. Secondary measures included the Insomnia Severity Index, Fatigue Severity Scale, Brief Fatigue Inventory (BFI), Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale.
Results
At follow-up, CBT recipients reported better sleep quality than those receiving TAU (PSQI mean difference, 4.85; 95% confidence interval [CI], 2.56–7.14). Daily fatigue levels were significantly reduced in the CBT group (BFI difference, 1.54; 95% CI, 0.66–2.42). Secondary improvements were significant for depression. Large within-group effect sizes were evident across measures (Hedges g=1.14–1.93), with maintenance of gains 2 months after therapy cessation.
Conclusions
Adapted CBT produced greater and sustained improvements in sleep, daily fatigue levels, and depression compared with TAU. These pilot findings suggest that CBT is a promising treatment for sleep disturbance and fatigue after TBI.
| Original language | English |
|---|---|
| Pages (from-to) | 1508-1517 |
| Number of pages | 10 |
| Journal | Archives of Physical Medicine and Rehabilitation |
| Volume | 98 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 2017 |
Keywords
- Brain injuries
- Cognitive therapy
- Fatigue
- Rehabilitation
- Sleep
- Traumatic
Cite this
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Cognitive Behavior Therapy to Treat Sleep Disturbance and Fatigue After Traumatic Brain Injury : A Pilot Randomized Controlled Trial. / Nguyen, Sylvia; McKay, Adam John Davy; Wong, Dana; Rajaratnam, Shantha M; Spitz, Gershon; Williams, Gavin; Mansfield, Darren; Ponsford, Jennie L.
In: Archives of Physical Medicine and Rehabilitation, Vol. 98, No. 8, 08.2017, p. 1508-1517.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Cognitive Behavior Therapy to Treat Sleep Disturbance and Fatigue After Traumatic Brain Injury
T2 - A Pilot Randomized Controlled Trial
AU - Nguyen, Sylvia
AU - McKay, Adam John Davy
AU - Wong, Dana
AU - Rajaratnam, Shantha M
AU - Spitz, Gershon
AU - Williams, Gavin
AU - Mansfield, Darren
AU - Ponsford, Jennie L.
PY - 2017/8
Y1 - 2017/8
N2 - ObjectiveTo evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI).DesignParallel 2-group randomized controlled trial.SettingOutpatient therapy.ParticipantsAdults (N=24) with history of TBI and clinically significant sleep and/or fatigue complaints were randomly allocated to an 8-session adapted CBT intervention or a treatment as usual (TAU) condition.InterventionsCognitive behavior therapy.Main Outcome MeasuresThe primary outcome was the Pittsburgh Sleep Quality Index (PSQI) posttreatment and at 2-month follow-up. Secondary measures included the Insomnia Severity Index, Fatigue Severity Scale, Brief Fatigue Inventory (BFI), Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale.ResultsAt follow-up, CBT recipients reported better sleep quality than those receiving TAU (PSQI mean difference, 4.85; 95% confidence interval [CI], 2.56–7.14). Daily fatigue levels were significantly reduced in the CBT group (BFI difference, 1.54; 95% CI, 0.66–2.42). Secondary improvements were significant for depression. Large within-group effect sizes were evident across measures (Hedges g=1.14–1.93), with maintenance of gains 2 months after therapy cessation.ConclusionsAdapted CBT produced greater and sustained improvements in sleep, daily fatigue levels, and depression compared with TAU. These pilot findings suggest that CBT is a promising treatment for sleep disturbance and fatigue after TBI.
AB - ObjectiveTo evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI).DesignParallel 2-group randomized controlled trial.SettingOutpatient therapy.ParticipantsAdults (N=24) with history of TBI and clinically significant sleep and/or fatigue complaints were randomly allocated to an 8-session adapted CBT intervention or a treatment as usual (TAU) condition.InterventionsCognitive behavior therapy.Main Outcome MeasuresThe primary outcome was the Pittsburgh Sleep Quality Index (PSQI) posttreatment and at 2-month follow-up. Secondary measures included the Insomnia Severity Index, Fatigue Severity Scale, Brief Fatigue Inventory (BFI), Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale.ResultsAt follow-up, CBT recipients reported better sleep quality than those receiving TAU (PSQI mean difference, 4.85; 95% confidence interval [CI], 2.56–7.14). Daily fatigue levels were significantly reduced in the CBT group (BFI difference, 1.54; 95% CI, 0.66–2.42). Secondary improvements were significant for depression. Large within-group effect sizes were evident across measures (Hedges g=1.14–1.93), with maintenance of gains 2 months after therapy cessation.ConclusionsAdapted CBT produced greater and sustained improvements in sleep, daily fatigue levels, and depression compared with TAU. These pilot findings suggest that CBT is a promising treatment for sleep disturbance and fatigue after TBI.
KW - Brain injuries
KW - Cognitive therapy
KW - Fatigue
KW - Rehabilitation
KW - Sleep
KW - Traumatic
UR - http://www.scopus.com/inward/record.url?scp=85021785176&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2017.02.031
DO - 10.1016/j.apmr.2017.02.031
M3 - Article
VL - 98
SP - 1508
EP - 1517
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 8
ER -