Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center , Kansas City, Kansas, USA.
A.R. Dykes Library, University of Kansas Medical Center , Kansas City, Kansas, USA.
Brain Inj. 2020 Oct 14;34(12):1569-1578. doi: 10.1080/02699052.2020.1831070. Epub 2020 Oct 28.
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.
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.
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.
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.
创伤性脑损伤（TBI）后常出现失眠症状。认知行为疗法（CBT）治疗睡眠障碍和失眠（CBT-I）已被用于改善睡眠结果。目前尚不清楚 CBT/CBT-I 是否对 TBI 患者有效。本综述旨在评估 CBT/CBT-I 在同时伴有失眠和伴随症状的 TBI 患者中的应用。
2019 年 6 月进行文献检索。共发现 861 篇文章。对 14 篇文章的全文进行了评估，以确定其是否符合纳入/排除标准。进行质量评估以评估偏倚风险。
符合标准的文章有 5 篇。其中 2 篇为试验性随机对照试验，3 篇为病例研究。综述表明，接受 CBT/CBT-I 的个体报告睡眠效率、睡眠质量提高，失眠症状和伴随症状减少。所有研究的主要偏倚来源是参与者数量有限。
本综述提供的证据表明，TBI 后进行 CBT/CBT-I 可以改善睡眠结果并减少伴随症状。由于随机对照试验数量有限，需要进行更多的研究来确定 CBT/CBT-I 是否对 TBI 患者有效。
