Efficacy of Cognitive-Behavioral Therapy for Insomnia Associated With Traumatic Brain Injury: A Single-Case Experimental Design
Presented in part to the Association for the Advancement of Behavior Therapy, November 2003, Boston, MA.
Abstract
Ouellet M-C, Morin CM. Efficacy of cognitive-behavioral therapy for insomnia associated with traumatic brain injury: a single-case experimental design.
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.
aAxe de Recherche en Traumatologie et Médecine d’Urgence, Centre de Recherche du Centre Hospitalier Affilié Universitaire de Québec, Québec, QC, Canada
bÉcole de psychologie, Université Laval, Québec, QC, Canada.
Reprint requests to Marie-Christine Ouellet, PhD, Recherche en Traumatologie et Médecine d’urgence Hopital de l’Enfant-Jésus du CHA 1401, 18e Rue, Québec, QC G1J 1Z4, Canada
Supported by the Fonds de la Recherche en Santé du Québec.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT