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Clin Rehabil. 2018 May;32(5):619-629. doi: 10.1177/0269215517736671. Epub 2017 Oct 26.

A pilot randomized controlled trial of on-line interventions to improve sleep quality in adults after mild or moderate traumatic brain injury.

Author information

1
1 National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
2
2 School of Psychology, The University of Auckland, Auckland, New Zealand.
3
3 School of Psychology, The University of Waikato, Hamilton, New Zealand.
4
4 Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada.

Abstract

OBJECTIVE:

To explore feasibility and potential efficacy of on-line interventions for sleep quality following a traumatic brain injury (TBI).

DESIGN:

A two parallel-group, randomized controlled pilot study.

SETTING:

Community-based.

SUBJECTS:

In all, 24 participants (mean age: 35.9 ± 11.8 years) who reported experiencing sleep difficulties between 3 and 36 months after a mild or moderate TBI.

INTERVENTIONS:

Participants were randomized to receive either a cognitive behaviour therapy or an education intervention on-line. Both interventions were self-completed for 20-30 minutes per week over a six-week period.

MAIN MEASURES:

The Pittsburgh Sleep Quality Index assessed self-reported sleep quality with actigraphy used as an objective measure of sleep quality. The CNS Vital Signs on-line neuropsychological test assessed cognitive functioning and the Rivermead Post-concussion Symptoms and Quality of Life after Brain Injury questionnaires were completed pre and post intervention.

RESULTS:

Both programmes demonstrated feasibility for use post TBI, with 83.3% of participants completing the interventions. The cognitive behaviour therapy group experienced significant reductions ( F = 5.47, p = 0.04) in sleep disturbance (mean individual change = -4.00) in comparison to controls post intervention (mean individual change = -1.50) with a moderate effect size of 1.17. There were no significant group differences on objective sleep quality, cognitive functioning, post-concussion symptoms or quality of life.

CONCLUSION:

On-line programmes designed to improve sleep are feasible for use for adults following mild-to-moderate TBI. Based on the effect size identified in this pilot study, 128 people (64 per group) would be needed to determine clinical effectiveness.

KEYWORDS:

Traumatic brain injury; cognitive behavioural therapy; education; sleep

PMID:
29072086
DOI:
10.1177/0269215517736671

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