TY  - JOUR
PY  - 2021//
TI  - Cognitive behavioural therapy versus health education for sleep disturbance and fatigue after acquired brain injury: a pilot randomised trial
JO  - Annals of physical and rehabilitation medicine
A1  - Ymer, Lucy
A1  - McKay, Adam
A1  - Wong, Dana
A1  - Frencham, Kate
A1  - Grima, Natalie
A1  - Tran, Joanna
A1  - Nguyen, Sylvia
A1  - Junge, Moira
A1  - Murray, Jade
A1  - Spitz, Gershon
A1  - Ponsford, Jennie
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Sleep disturbance and fatigue are highly prevalent after acquired brain injury (ABI) and are associated with poor functional outcomes. Cognitive behavioural therapy (CBT) is a promising treatment for sleep and fatigue problems after ABI, although comparison with an active control is needed to establish efficacy. <br><br>OBJECTIVES: We compared CBT for sleep disturbance and fatigue (CBT-SF) with a health education (HE) intervention to control for non-specific therapy effects. <br><br>METHODS: In a parallel-group, pilot randomised controlled trial, 51 individuals with traumatic brain injury (n=22) and stroke (n=29) and clinically significant sleep and/or fatigue problems were randomised 2:1 to 8 weeks of a CBT-SF (n=34) or HE intervention (n=17), both adapted for cognitive impairments. Participants were assessed at baseline, post-treatment, and 2 and 4 months post-treatment. The primary outcome was the Pittsburgh Sleep Quality Index; secondary outcomes included measures of fatigue, sleepiness, mood, quality of life, activity levels, self-efficacy and actigraphy sleep measures. <br><br>RESULTS: The CBT-SF led to significantly greater improvements in sleep quality as compared with HE, during treatment and at 2 months [95% confidence interval (CI) -24.83; -7.71], as well as significant reductions in fatigue maintained at all time points, which were not evident with HE (95% CI -1.86; 0.23). HE delayed improvement in sleep quality at 4 months post-treatment and in depression (95% CI -1.37; -0.09) at 2 months post-treatment. CBT-SF led to significant gains in self-efficacy (95% CI 0.15; 0.53) and mental health (95% CI 1.82; 65.06). <br><br>CONCLUSIONS: CBT-SF can be an effective treatment option for sleep disturbance and fatigue after ABI, over and above HE. HE may provide delayed benefit for sleep, possibly by improving mood. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry: ACTRN12617000879369 (registered 15/06/2017) and ACTRN12617000878370 (registered 15/06/2017).<p />  <p>Language: en</p>
LA  - en
SN  - 1877-0657
UR  - http://dx.doi.org/10.1016/j.rehab.2021.101560
ID  - ref1
ER  -