ABSTRACT

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.

中文翻译：

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认知行为疗法是否能改善脑外伤患者的睡眠结局：一项范围回顾

摘要

背景

颅脑外伤（TBI）后，失眠症状很常见。认知行为疗法（CBT）用于治疗睡眠障碍和失眠（CBT-1）已用于改善睡眠结局。尚不清楚CBT / CBT-1在患有TBI的个体中是否有效。进行该评价以评估CBT / CBT-1在患有TBI的患者中的使用，该患者也支持失眠和伴随症状。

方法

文献检索于2019年6月进行。共找到861条文章。对14篇文章的全文进行了审查，以纳入/排除标准。进行质量评估以评估偏差的风险。

结果

五篇文章符合标准。两篇文章是飞行员随机对照试验，三篇是案例研究。该评价表明参加CBT / CBT-1的个体报告了睡眠效率提高，睡眠质量提高，失眠症状和伴随症状减轻。偏见的主要来源是所有研究中参与者的数量有限。

结论

这篇综述提供了证据，证明TBI后的CBT / CBT-I可以改善睡眠结果并减轻伴随的症状。由于有限的随机对照试验以确定CBT / CBT-1在TBI患者中是否有效，因此需要更强有力的研究。