Development and Evaluation of a Cognitive Behavioural Intervention for Chronic Post-Stroke Insomnia

Area of Science:

• Neurology
• Sleep Medicine
• Psychiatry

Background:

• Insomnia is prevalent in post-stroke individuals, yet Cognitive Behavioural Therapy for Insomnia (CBTI) is underutilized.
• Existing research on CBTI for post-stroke insomnia is limited, hindering clinical application.

Purpose of the Study:

• To develop and assess the efficacy of a modified CBTI protocol, termed 'CBTI+', for individuals experiencing post-stroke insomnia.
• The CBTI+ protocol integrates additional strategies to address stroke-specific challenges.

Main Methods:

• A single-case experimental design involved five community-dwelling participants with post-stroke insomnia.
• Data collection included 11 weeks of sleep diaries, with baseline, intervention, and follow-up periods.
• Standardized questionnaires assessed insomnia severity, sleep beliefs, daytime sleepiness, fatigue, and stroke impact.

Main Results:

• Following the CBTI+ intervention, three participants no longer met insomnia diagnostic criteria.
• All participants demonstrated improvements in sleep duration and sleep onset latency.
• Significant reductions in daytime sleepiness and unhelpful sleep-related beliefs were observed in three participants.

Conclusions:

• The CBTI+ protocol is a feasible and acceptable intervention for managing insomnia in stroke survivors.
• Unhelpful beliefs and behaviors contribute to persistent sleep difficulties in the post-stroke population.
• This study has clinical implications for post-stroke care and identifies avenues for future research.