Psychotherapy Research Today is a free monthly online journal that collates and summarizes the latest research about Psychotherapy, including details on psychiatry, psychoanalysis, methods, outcomes.

Efficacy of cognitive-behavioral therapy for insomnia associated with traumatic brain injury: a single-case experimental design.

Ouellet MC, Morin CM

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

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.

Published 30 November 2007 in Arch Phys Med Rehabil, 88(12): 1581-92.
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