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Cognitive Behavioral Therapy for Insomnia Improves Sleep Outcomes in Individuals With Concussion: A Preliminary
Rebecca Ludwig1, Michael Rippee, Linda D'Silva
1Departments of Physical Therapy, Rehabilitation Science, and Athletic Training (Ms Ludwig and Drs D'Silva and Siengsukon), Neurology (Dr Rippee), Occupational Therapy and Therapeutic Science (Dr Radel), and Biostatistics and Data Science (Mr Beltramo), University of Kansas Medical Center, Kansas City; Department of Occupational Therapy, Colorado State University, Fort Collins (Dr Eakman); and Neurological Institute, Sleep Disorders Center, Cleveland Clinic, Cleveland, Ohio (Dr Drerup).
Cognitive behavioral therapy for insomnia (CBT-I) effectively treats insomnia in individuals post-concussion. Improved sleep with CBT-I correlated with reduced concussion and mood symptoms, with effects sustained post-intervention.
Area of Science:
- Neurology
- Sleep Medicine
- Psychiatry
Background:
- Insomnia is common after concussion, impacting recovery.
- Cognitive behavioral therapy for insomnia (CBT-I) is a proven insomnia treatment.
- Evidence for CBT-I in post-concussion populations is limited.
Purpose of the Study:
- To evaluate the effectiveness of CBT-I for insomnia in individuals after a concussion.
- To assess the impact of CBT-I on post-concussion symptoms and mood.
Main Methods:
- A randomized controlled wait-list study design was employed.
- Participants (n=32) were randomized to immediate CBT-I or a 6-week wait-list.
- Teleconferencing delivered CBT-I; assessments occurred at baseline, 6, 12, and 18 weeks.
Main Results:
- Significant improvements in sleep outcomes were observed in the CBT-I group compared to the wait-list.
- Reductions in post-concussion symptom severity and depression were noted.
- Treatment effects on sleep, concussion, and mood symptoms were maintained for 6-12 weeks post-intervention.
Conclusions:
- CBT-I is an effective treatment for insomnia in individuals with a history of concussion.
- Improved sleep following CBT-I is associated with decreased post-concussion and mood symptoms.
- The benefits of CBT-I for post-concussion insomnia are durable.
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