Does cognitive-behavioural therapy improve sleep outcomes in individuals with traumatic brain injury: a scoping review.

BACKGROUND

Insomnia symptoms are common after a traumatic brain injury (TBI). Cognitive-behavioural therapy (CBT) to treat sleep disturbances and insomnia (CBT-I) has been used to improve sleep outcomes. It is unclear if CBT/CBT-I is efficacious in individuals with a TBI. This review was performed to evaluate the use of CBT/CBT-I in individuals with a TBI who also endorse insomnia and concomitant symptoms.

METHODS

Literature searches were conducted in June 2019. A total of 861 articles were found. The full text of 14 articles was reviewed for inclusion/exclusion criteria. Quality appraisal was conducted to assess the risk of bias.

RESULTS

Five articles met the criteria. Two articles were pilot-randomized control trials and three were case studies. The review indicates that individuals participating in CBT/CBT-I reported increased sleep efficiency, sleep quality, and reduced insomnia symptoms and concomitant symptoms. The major source of bias is a limited number of participants across all studies.

CONCLUSION

This review provides evidence that CBT/CBT-I following a TBI can improve sleep outcomes and reduce concomitant symptoms. More robust studies are needed due to limited number of randomized control trials to determine if CBT/CBT-I is an effective treatment in individuals with TBI.