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The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
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Telephone Problem-Solving Treatment Improves Sleep Quality in Service Members With Combat-Related Mild Traumatic

S Vuletic1, K R Bell, S Jain

  • 1National Center for Telehealth and Technology (T2), Tacoma, Washington (Drs Vuletic, Bush, Stanfill, and Gahm); Departments of Rehabilitation Medicine (Drs Bell, Temkin, Dikmen, and Brockway), Neurological Surgery (Drs Temkin and Dikmen), Biostatistics (Drs Temkin and Fann), and Psychiatry and Behavioral Sciences (Dr Fann), University of Washington, Seattle; Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas (Dr Bell); Departments of Family Medicine and Public Health (Drs Jain, Raman, and Stein and Messrs He and Ernstrom) and Psychiatry (Dr Stein), University of California San Diego, La Jolla; Department of Neurosurgery, Stanford University School of Medicine, Stanford, California (Dr Grant); and Defense Centers of Excellence (DCoE), Olympia, Washington (Dr Gahm).

The Journal of Head Trauma Rehabilitation
|March 10, 2016
PubMed
Summary

Telephone-based problem-solving treatment (PST) improved sleep quality in service members with mild traumatic brain injury (mTBI) at six months. Poor sleep quality correlated with concussion symptoms, pain, depression, and PTSD.

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Area of Science:

  • Neuroscience
  • Sleep Medicine
  • Military Health

Background:

  • Sleep disturbances are prevalent in postdeployment service members with mild traumatic brain injury (mTBI).
  • These sleep issues are often linked to co-occurring conditions such as pain, depression, and posttraumatic stress disorder (PTSD).

Purpose of the Study:

  • To assess sleep quality and its associated factors in active duty service members following deployment and mTBI.
  • To evaluate the efficacy of telephone-based problem-solving treatment (PST) compared to an education-only (EO) control group for improving sleep quality.

Main Methods:

  • A randomized clinical trial involving 356 active duty service members with combat-related mTBI.
  • Participants were assigned to either an education-only (EO) group or a PST group, receiving up to 12 telephone-based PST sessions.
  • Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) at baseline, 6 months, and 12 months postintervention.

Main Results:

  • Both groups exhibited poor sleep quality at baseline (PSQI score = 12.5 ± 4).
  • The PST group showed significantly improved sleep quality compared to the EO group at the 6-month follow-up (P = .003).
  • Poor sleep quality was consistently associated with concussion symptoms, pain, depression, and PTSD (P < .0001) across all time points.

Conclusions:

  • Sleep disorders are common and significantly associated with pain, PTSD, and depression in service members with mTBI.
  • Telephone-based PST demonstrates potential as an effective intervention for mitigating sleep disorders in this population.
  • Further research is needed to explore methods for sustaining the treatment gains achieved through PST.