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Arch Phys Med Rehabil. 2004 Aug;85(8):1298-302.

Cognitive behavioral therapy for insomnia associated with traumatic brain injury: a single-case study.

Author information

  • 1Ecole de Psychologie, Centre d'Etude des Troubles du Sommeil, UniversitĂ© Laval, QuĂ©bec City, QC, Canada. mcouellet@psy.ulaval.ca

Abstract

OBJECTIVE:

To test the efficacy of a cognitive behavioral therapy (CBT) for insomnia with a patient with traumatic brain injury (TBI).

DESIGN:

Single-case study.

SETTING:

Outpatient rehabilitation center.

PARTICIPANT:

A man in his late thirties who sustained a moderate TBI in a motor vehicle crash and who developed insomnia. He complained of difficulties falling asleep and staying asleep, despite pharmacotherapy with zopiclone.

INTERVENTIONS:

Eight weekly individual CBT sessions. Treatment included stimulus control, sleep restriction, cognitive therapy, and sleep hygiene education.

MAIN OUTCOME MEASURES:

Sleep diary and polysomnography data.

RESULTS:

Sleep onset decreased from 47 to 18 minutes, and nocturnal awakenings dropped from 85 to 28 minutes on average at posttreatment. Sleep efficiency also increased substantially (58% to 83%). Polysomnography evaluations corroborated the diary data by showing a decrease in total time awake (63.2 to 26.3 min) and in the number of awakenings (21 to 7.5). The majority of gains were well maintained at 1- and 3-month follow-up assessments.

CONCLUSIONS:

These preliminary results suggest that sleep disturbances after TBI can be alleviated with a nonpharmacologic intervention. CBT for post-TBI insomnia is a promising therapeutic avenue deserving more scientific and clinical attention.

PMID:
15295756
[PubMed - indexed for MEDLINE]
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