Cognitive Behavior Therapy to Treat Sleep Disturbance and Fatigue After Traumatic Brain Injury: A Pilot Randomized Controlled Trial
To evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI). Parallel 2-group randomized controlled trial. Outpatient therapy. Adults (N=24) with history of TBI and clinically significant sleep and/or fatig...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2017-08, Vol.98 (8), p.1508-1517.e2 |
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| container_title | Archives of physical medicine and rehabilitation |
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| creator | Nguyen, Sylvia McKay, Adam Wong, Dana Rajaratnam, Shantha M. Spitz, Gershon Williams, Gavin Mansfield, Darren Ponsford, Jennie L. |
| description | To evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI).
Parallel 2-group randomized controlled trial.
Outpatient therapy.
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.
Cognitive behavior therapy.
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.
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.
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. |
| doi_str_mv | 10.1016/j.apmr.2017.02.031 |
| format | Article |
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Parallel 2-group randomized controlled trial.
Outpatient therapy.
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.
Cognitive behavior therapy.
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.
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.
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.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2017.02.031</identifier><identifier>PMID: 28400181</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Brain injuries ; Brain Injuries, Traumatic - complications ; Cognitive therapy ; Cognitive Therapy - methods ; Fatigue ; Fatigue - etiology ; Fatigue - therapy ; Female ; Glasgow Coma Scale ; Health Status ; Humans ; Male ; Mental Health ; Middle Aged ; Pilot Projects ; Quality of Life ; Rehabilitation ; Severity of Illness Index ; Sleep ; Sleep Wake Disorders - etiology ; Sleep Wake Disorders - therapy ; Traumatic</subject><ispartof>Archives of physical medicine and rehabilitation, 2017-08, Vol.98 (8), p.1508-1517.e2</ispartof><rights>2017 American Congress of Rehabilitation Medicine</rights><rights>Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-1e909ec4c2b0b34fd842cff0069f7fdea67c9ee895cfe87c9b7a16e97d5ee3903</citedby><cites>FETCH-LOGICAL-c356t-1e909ec4c2b0b34fd842cff0069f7fdea67c9ee895cfe87c9b7a16e97d5ee3903</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.apmr.2017.02.031$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28400181$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nguyen, Sylvia</creatorcontrib><creatorcontrib>McKay, Adam</creatorcontrib><creatorcontrib>Wong, Dana</creatorcontrib><creatorcontrib>Rajaratnam, Shantha M.</creatorcontrib><creatorcontrib>Spitz, Gershon</creatorcontrib><creatorcontrib>Williams, Gavin</creatorcontrib><creatorcontrib>Mansfield, Darren</creatorcontrib><creatorcontrib>Ponsford, Jennie L.</creatorcontrib><title>Cognitive Behavior Therapy to Treat Sleep Disturbance and Fatigue After Traumatic Brain Injury: A Pilot Randomized Controlled Trial</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>To evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI).
Parallel 2-group randomized controlled trial.
Outpatient therapy.
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.
Cognitive behavior therapy.
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.
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.
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.</description><subject>Adult</subject><subject>Brain injuries</subject><subject>Brain Injuries, Traumatic - complications</subject><subject>Cognitive therapy</subject><subject>Cognitive Therapy - methods</subject><subject>Fatigue</subject><subject>Fatigue - etiology</subject><subject>Fatigue - therapy</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>Health Status</subject><subject>Humans</subject><subject>Male</subject><subject>Mental Health</subject><subject>Middle Aged</subject><subject>Pilot Projects</subject><subject>Quality of Life</subject><subject>Rehabilitation</subject><subject>Severity of Illness Index</subject><subject>Sleep</subject><subject>Sleep Wake Disorders - etiology</subject><subject>Sleep Wake Disorders - therapy</subject><subject>Traumatic</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtP3DAUha0KVKa0f6CLyks2Sf3Iy4jNMC0FCQnUTqXuLMe5Bo-SOLWdkaZb_ng9GmDJ6j50zpHOh9BnSnJKaPV1k6tp8DkjtM4Jywmn79CClpxlDaN_jtCCEMIzIQQ_QR9C2KSzKjl9j05YUxBCG7pATyv3MNpot4Av4VFtrfN4_QheTTscHV57UBH_6gEm_M2GOPtWjRqwGjt8paJ9mAEvTYRk8moe0kfjS6_siG_Gzex353iJ723vIv6ZLG6w_6DDKzdG7_o-rWtvVf8RHRvVB_j0PE_R76vv69V1dnv342a1vM00L6uYURBEgC40a0nLC9M1BdPGpFLC1KYDVdVaADSi1AaatLe1ohWIuisBuCD8FJ0dcifv_s4Qohxs0ND3agQ3B0mbpiYlpUWVpOwg1d6F4MHIydtB-Z2kRO7hy43cw5d7-JIwmeAn05fn_LkdoHu1vNBOgouDAFLLrQUvg7aQeHbWg46yc_at_P8ZnZfY</recordid><startdate>201708</startdate><enddate>201708</enddate><creator>Nguyen, Sylvia</creator><creator>McKay, Adam</creator><creator>Wong, Dana</creator><creator>Rajaratnam, Shantha M.</creator><creator>Spitz, Gershon</creator><creator>Williams, Gavin</creator><creator>Mansfield, Darren</creator><creator>Ponsford, Jennie L.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201708</creationdate><title>Cognitive Behavior Therapy to Treat Sleep Disturbance and Fatigue After Traumatic Brain Injury: A Pilot Randomized Controlled Trial</title><author>Nguyen, Sylvia ; McKay, Adam ; Wong, Dana ; Rajaratnam, Shantha M. ; Spitz, Gershon ; Williams, Gavin ; Mansfield, Darren ; Ponsford, Jennie L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-1e909ec4c2b0b34fd842cff0069f7fdea67c9ee895cfe87c9b7a16e97d5ee3903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Brain injuries</topic><topic>Brain Injuries, Traumatic - complications</topic><topic>Cognitive therapy</topic><topic>Cognitive Therapy - methods</topic><topic>Fatigue</topic><topic>Fatigue - etiology</topic><topic>Fatigue - therapy</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>Health Status</topic><topic>Humans</topic><topic>Male</topic><topic>Mental Health</topic><topic>Middle Aged</topic><topic>Pilot Projects</topic><topic>Quality of Life</topic><topic>Rehabilitation</topic><topic>Severity of Illness Index</topic><topic>Sleep</topic><topic>Sleep Wake Disorders - etiology</topic><topic>Sleep Wake Disorders - therapy</topic><topic>Traumatic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nguyen, Sylvia</creatorcontrib><creatorcontrib>McKay, Adam</creatorcontrib><creatorcontrib>Wong, Dana</creatorcontrib><creatorcontrib>Rajaratnam, Shantha M.</creatorcontrib><creatorcontrib>Spitz, Gershon</creatorcontrib><creatorcontrib>Williams, Gavin</creatorcontrib><creatorcontrib>Mansfield, Darren</creatorcontrib><creatorcontrib>Ponsford, Jennie L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nguyen, Sylvia</au><au>McKay, Adam</au><au>Wong, Dana</au><au>Rajaratnam, Shantha M.</au><au>Spitz, Gershon</au><au>Williams, Gavin</au><au>Mansfield, Darren</au><au>Ponsford, Jennie L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cognitive Behavior Therapy to Treat Sleep Disturbance and Fatigue After Traumatic Brain Injury: A Pilot Randomized Controlled Trial</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2017-08</date><risdate>2017</risdate><volume>98</volume><issue>8</issue><spage>1508</spage><epage>1517.e2</epage><pages>1508-1517.e2</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><abstract>To evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI).
Parallel 2-group randomized controlled trial.
Outpatient therapy.
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.
Cognitive behavior therapy.
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.
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.
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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28400181</pmid><doi>10.1016/j.apmr.2017.02.031</doi></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Brain injuries Brain Injuries, Traumatic - complications Cognitive therapy Cognitive Therapy - methods Fatigue Fatigue - etiology Fatigue - therapy Female Glasgow Coma Scale Health Status Humans Male Mental Health Middle Aged Pilot Projects Quality of Life Rehabilitation Severity of Illness Index Sleep Sleep Wake Disorders - etiology Sleep Wake Disorders - therapy Traumatic |
| title | Cognitive Behavior Therapy to Treat Sleep Disturbance and Fatigue After Traumatic Brain Injury: A Pilot Randomized Controlled Trial |
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