S'abonner

Cognitive behavioural therapy versus health education for sleep disturbance and fatigue after acquired brain injury: a pilot randomised trial - 24/07/21

Doi : 10.1016/j.rehab.2021.101560 
Lucy Ymer, DPsych 1, 2, , Adam McKay, PhD 1, 2, 3, Dana Wong, PhD 1, 2, 4, Kate Frencham, PhD 2, Natalie Grima, DPsych 1, 2, Joanna Tran, MPsych 2, Sylvia Nguyen, DPsych 2, 3, Moira Junge, DPsych 1, Jade Murray, PhD 1, 2, Gershon Spitz, PhD 1, 2, Jennie Ponsford, PhD 1, 2
1 Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia 
2 Monash Epworth Rehabilitation Research Centre, Melbourne, VIC, Australia 
3 Department of Psychology, Epworth Rehabilitation, Melbourne, VIC, Australia 
4 School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia 

Corresponding author: Lucy Ymer, Monash Epworth Rehabilitation Research Centre, 185-187 Hoddle St, Richmond, VIC, Australia 3121Monash Epworth Rehabilitation Research Centre185-187 Hoddle StRichmondVIC3121Australia
Sous presse. Manuscrit accepté. Disponible en ligne depuis le Saturday 24 July 2021
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Highlights

Sleep disturbance and fatigue are highly prevalent after acquired brain injury.
Cognitive behavioural therapy improves sleep disturbance and fatigue after injury.
This 8-week treatment is adapted to support individuals with cognitive impairments.
Benefits of cognitive behavioural therapy extend over and above health education.
Additional treatment benefits include improved self-efficacy and quality of life.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

Sleep disturbance and fatigue are highly prevalent after acquired brain injury (ABI) and are associated with poor functional outcomes. Cognitive behavioural therapy (CBT) is a promising treatment for sleep and fatigue problems after ABI, although comparison with an active control is needed to establish efficacy.

Objectives

We compared CBT for sleep disturbance and fatigue (CBT-SF) with a health education (HE) intervention to control for non-specific therapy effects.

Methods

In a parallel-group, pilot randomised controlled trial, 51 individuals with traumatic brain injury (n=22) and stroke (n=29) and clinically significant sleep and/or fatigue problems were randomised 2:1 to 8 weeks of a CBT-SF (n=34) or HE intervention (n=17), both adapted for cognitive impairments. Participants were assessed at baseline, post-treatment, and 2 and 4 months post-treatment. The primary outcome was the Pittsburgh Sleep Quality Index; secondary outcomes included measures of fatigue, sleepiness, mood, quality of life, activity levels, self-efficacy and actigraphy sleep measures.

Results

The CBT-SF led to significantly greater improvements in sleep quality as compared with HE, during treatment and at 2 months [95% confidence interval (CI) -24.83; -7.71], as well as significant reductions in fatigue maintained at all time points, which were not evident with HE (95% CI -1.86; 0.23). HE delayed improvement in sleep quality at 4 months post-treatment and in depression (95% CI -1.37; -0.09) at 2 months post-treatment. CBT-SF led to significant gains in self-efficacy (95% CI 0.15; 0.53) and mental health (95% CI 1.82; 65.06). Conclusions. CBT-SF can be an effective treatment option for sleep disturbance and fatigue after ABI, over and above HE. HE may provide delayed benefit for sleep, possibly by improving mood.

Trial Registration

Australia New Zealand Clinical Trials Registry: ACTRN12617000879369 (registered 15/06/2017) and ACTRN12617000878370 (registered 15/06/2017).

Le texte complet de cet article est disponible en PDF.

Keywords : cognitive behavioural therapy, acquired brain injury, sleep, fatigue, health education


Plan


 Conflict of Interest. None declared
 Funding. This work was partly supported by the National Health and Medical Research Council (grant nos. APP1174473, APP1023043)


© 2021  Publié par Elsevier Masson SAS.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.


Tout le contenu de ce site: Copyright © 2024 Elsevier, ses concédants de licence et ses contributeurs. Tout les droits sont réservés, y compris ceux relatifs à l'exploration de textes et de données, a la formation en IA et aux technologies similaires. Pour tout contenu en libre accès, les conditions de licence Creative Commons s'appliquent.