@article{ref1,
title="Cognitive behavior therapy to treat sleep disturbance and fatigue following traumatic brain injury: a pilot randomized controlled trial",
journal="Archives of physical medicine and rehabilitation",
year="2017",
author="Nguyen, Sylvia and McKay, Adam and Wong, Dana and Rajaratnam, S. M. and Spitz, Gershon and Williams, Gavin and Mansfield, Darren and Ponsford, Jennie L.",
volume="98",
number="8",
pages="1508-1517.e2",
abstract="OBJECTIVE: To evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI). <br><br>DESIGN: Parallel two-group randomized controlled trial. SETTING: Outpatient therapy in the Melbourne metropolitan area. PARTICIPANTS: Twenty-four adults with history of TBI and clinically significant sleep and/or fatigue complaints were randomly allocated to an eight-session adapted CBT intervention or a treatment as usual (TAU) condition. MAIN OUTCOME MEASURES: The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) post-treatment and at two month follow-up. Secondary measures included Insomnia Severity Scale, Fatigue Severity Scale, Brief Fatigue Inventory, Epworth Sleepiness Scale and Hospital Anxiety and Depression Scale. <br><br>RESULTS: At follow-up, CBT recipients reported better sleep quality than those receiving TAU (PSQI mean difference 4.85, 95%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 two months after therapy cessation. <br><br>CONCLUSIONS: Adapted CBT produced greater and sustained improvements in sleep, daily fatigue levels and depression compared to TAU. These pilot findings suggest that CBT is a promising treatment for sleep disturbance and fatigue after TBI.<br><br>Copyright © 2017. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2017.02.031",
url="http://dx.doi.org/10.1016/j.apmr.2017.02.031"
}