Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury
Objective: Evaluate efficacy of cognitive behavioural therapy for sleep and fatigue adapted for brain injury relative to health education control in alleviating sleep disturbance and fatigue after acquired brain injury. Design: Parallel groups randomized controlled trial. Subjects: 126 community d...
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| Language: | English |
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Medical Journals Sweden
2025-01-01
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| Series: | Journal of Rehabilitation Medicine |
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| Online Access: | https://medicaljournalssweden.se/jrm/article/view/41302 |
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| author | Lucy Ymer Adam McKay Dana Wong Kate Frencham Natalie Grima Monique Roper Sylvia Nguyen Jade Murray Gershon Spitz Jennie Ponsford |
| author_facet | Lucy Ymer Adam McKay Dana Wong Kate Frencham Natalie Grima Monique Roper Sylvia Nguyen Jade Murray Gershon Spitz Jennie Ponsford |
| author_sort | Lucy Ymer |
| collection | DOAJ |
| description | Objective: Evaluate efficacy of cognitive behavioural therapy for sleep and fatigue adapted for brain injury relative to health education control in alleviating sleep disturbance and fatigue after acquired brain injury.
Design: Parallel groups randomized controlled trial.
Subjects: 126 community dwelling adults with stroke or traumatic brain injury.
Methods: Participants were randomized 2:1 to receive 8-weeks of cognitive behavioural therapy for sleep and fatigue (n = 86) or health education (n = 40). The Pittsburgh Sleep Quality Index was assessed pre- and post-treatment, and 2 and 4-months post-treatment, with secondary measures of insomnia, fatigue, sleepiness, mood, quality of life, activity levels, self-efficacy, and actigraphy.
Results: Both groups showed improved sleep by 4-month follow-up. However, cognitive behavioural therapy for sleep and fatigue had significantly larger and more rapid improvements than health education immediately post-treatment (β = –1.50, p < 0.001, 95% confidence interval –2.35 to –0.64). There were no significant between-groups differences in fatigue; however, cognitive behavioural therapy for sleep and fatigue showed within-group gains on both fatigue measures immediately post-treatment and over time (β = –0.29, p = 0.047, 95% confidence interval –0.58 to –0.01). Health education had delayed improvements at 4-month follow-up on 1 fatigue measure.
Conclusions: Both cognitive behavioural therapy for sleep and fatigue and health education led to improvement in sleep and fatigue; however, effects were larger and more rapid for cognitive behavioural therapy for sleep and fatigue immediately post-treatment. This supports the efficacy of cognitive behavioural therapy for sleep and fatigue in acquired brain injury but also highlights that health education may result in delayed improvements in symptoms.
ANZCTR Trial registration numbers: 1261700087830; 12617000879369
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| format | Article |
| id | doaj-art-af7dcff0a9b24afbac10c62f9f50db76 |
| institution | Kabale University |
| issn | 1651-2081 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Journal of Rehabilitation Medicine |
| spelling | doaj-art-af7dcff0a9b24afbac10c62f9f50db762025-01-03T09:19:27ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812025-01-015710.2340/jrm.v57.41302Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injuryLucy Ymer0Adam McKay1Dana Wong2Kate Frencham3Natalie Grima4Monique Roper5Sylvia Nguyen6Jade Murray7Gershon Spitz8Jennie Ponsford9Monash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, AustraliaMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Epworth Healthcare, Melbourne, VIC, AustraliaMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; School of Psychology and Public Health, La Trobe University, Melbourne, VIC, AustraliaMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, AustraliaMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, AustraliaMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, AustraliaEpworth Healthcare, Melbourne, VIC, AustraliaMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, AustraliaMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, AustraliaMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Epworth Healthcare, Melbourne, VIC, AustraliaObjective: Evaluate efficacy of cognitive behavioural therapy for sleep and fatigue adapted for brain injury relative to health education control in alleviating sleep disturbance and fatigue after acquired brain injury. Design: Parallel groups randomized controlled trial. Subjects: 126 community dwelling adults with stroke or traumatic brain injury. Methods: Participants were randomized 2:1 to receive 8-weeks of cognitive behavioural therapy for sleep and fatigue (n = 86) or health education (n = 40). The Pittsburgh Sleep Quality Index was assessed pre- and post-treatment, and 2 and 4-months post-treatment, with secondary measures of insomnia, fatigue, sleepiness, mood, quality of life, activity levels, self-efficacy, and actigraphy. Results: Both groups showed improved sleep by 4-month follow-up. However, cognitive behavioural therapy for sleep and fatigue had significantly larger and more rapid improvements than health education immediately post-treatment (β = –1.50, p < 0.001, 95% confidence interval –2.35 to –0.64). There were no significant between-groups differences in fatigue; however, cognitive behavioural therapy for sleep and fatigue showed within-group gains on both fatigue measures immediately post-treatment and over time (β = –0.29, p = 0.047, 95% confidence interval –0.58 to –0.01). Health education had delayed improvements at 4-month follow-up on 1 fatigue measure. Conclusions: Both cognitive behavioural therapy for sleep and fatigue and health education led to improvement in sleep and fatigue; however, effects were larger and more rapid for cognitive behavioural therapy for sleep and fatigue immediately post-treatment. This supports the efficacy of cognitive behavioural therapy for sleep and fatigue in acquired brain injury but also highlights that health education may result in delayed improvements in symptoms. ANZCTR Trial registration numbers: 1261700087830; 12617000879369 https://medicaljournalssweden.se/jrm/article/view/41302acquired brain injurystrokesleepfatiguecognitive behavioural therapy |
| spellingShingle | Lucy Ymer Adam McKay Dana Wong Kate Frencham Natalie Grima Monique Roper Sylvia Nguyen Jade Murray Gershon Spitz Jennie Ponsford Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury Journal of Rehabilitation Medicine acquired brain injury stroke sleep fatigue cognitive behavioural therapy |
| title | Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury |
| title_full | Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury |
| title_fullStr | Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury |
| title_full_unstemmed | Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury |
| title_short | Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury |
| title_sort | randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury |
| topic | acquired brain injury stroke sleep fatigue cognitive behavioural therapy |
| url | https://medicaljournalssweden.se/jrm/article/view/41302 |
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