Cognitive Behavioral Therapy for Sleep Disturbance and Fatigue Following Acquired Brain Injury: Predictors of Treatment Response. Issue 3 (26th May 2022)

• Record Type: Journal Article
• Authors: Ymer, Lucy; McKay, Adam; Wong, Dana; Frencham, Kate; Grima, Natalie; Tran, Joanna; Nguyen, Sylvia; Ponsford, Jennie
• Is Part Of: Journal of head trauma rehabilitation. Volume 37:Issue 3(2022)
• Page Start: E220
• Page End: E230
• Publication Date: 2022-05-26
• Subjects: cognitive behavioral therapy -- fatigue -- sleep -- stroke -- traumatic brain injury; Brain damage -- Patients -- Rehabilitation -- Periodicals; Brain damage -- Periodicals; 617.4810443
• DOI: 10.1097/HTR.0000000000000705
• Languages: English
• ISSNs: 0885-9701

Abstract

Abstract : Objective: To identify factors associated with treatment response to cognitive behavioral therapy for sleep disturbance and fatigue (CBT-SF) after acquired brain injury (ABI). Setting: Community dwelling. Participants: Thirty participants with a traumatic brain injury or stroke randomized to receive CBT-SF in a parent randomized controlled trial. Design: Participants took part in a parallel-groups, parent randomized controlled trial with blinded outcome assessment, comparing an 8-week CBT-SF program with an attentionally equivalent health education control. They were assessed at baseline, post-treatment, 2 months post-treatment, and 4 months post-treatment. The study was completed either face-to-face or via telehealth (videoconferencing). Following this trial, a secondary analysis of variables associated with treatment response to CBT-SF was conducted, including: demographic variables; injury-related variables; neuropsychological characteristics; pretreatment sleep disturbance, fatigue, depression, anxiety and pain; and mode of treatment delivery (face-to-face or telehealth). Main Measures: Pittsburgh Sleep Quality Index (PSQI) and Fatigue Severity Scale (FSS). Results: Greater treatment response to CBT-SF at 4-month follow-up was associated with higher baseline sleep and fatigue symptoms. Reductions in fatigue on the FSS were also related to injury mechanism, where those with a traumatic brain injury had a more rapid and short-lasting improvement in fatigue, compared with those with stroke, who had a delayed but longer-term reduction in fatigue. Mode of treatment delivery did not significantly impact CBT-SF outcomes. Conclusion: Our findings highlight potential differences between fatigue trajectories in traumatic brain injury and stroke, and also provide preliminary support for the equivalence of face-to-face and telehealth delivery of CBT-SF in individuals with ABI.