Article

OBJECTIVE: To evaluate the efficacy of adapted cognitive behavioral therapy (CBT)
for sleep disturbance and fatigue in individuals with traumatic brain injury
(TBI). DESIGN: Parallel 2-group randomized controlled trial. SETTING: Outpatient
therapy. PARTICIPANTS:
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.
INTERVENTIONS: Cognitive behavior therapy. MAIN OUTCOME MEASURES:
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. RESULTS: 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. CONCLUSIONS: 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.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS