Cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic: a quality improvement project assessing the integration of a smartphone application with behavioral treatment
ObjectivesWhile the association between insomnia and traumatic brain injury (TBI) is well established, TBI rehabilitation programs that focus on sleep as a primary target are limited. Cognitive behavioral therapy for insomnia (CBTi) is an effective treatment for insomnia, however; its use within TBI...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Sleep |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frsle.2023.1268967/full |
| _version_ | 1797386037970862080 |
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| author | Justin T. Matsuura Nicole S. Keller Michael B. Lustik Carmen E. Campbell Chad E. Grills |
| author_facet | Justin T. Matsuura Nicole S. Keller Michael B. Lustik Carmen E. Campbell Chad E. Grills |
| author_sort | Justin T. Matsuura |
| collection | DOAJ |
| description | ObjectivesWhile the association between insomnia and traumatic brain injury (TBI) is well established, TBI rehabilitation programs that focus on sleep as a primary target are limited. Cognitive behavioral therapy for insomnia (CBTi) is an effective treatment for insomnia, however; its use within TBI clinics is relatively unknown. Therefore, our aim was to evaluate the implementation of CBTi, used in conjunction with a smartphone app for insomnia, within a US military TBI program to improve care within this setting.SettingA TBI clinic at a US military installation.MethodsMHS beneficiaries underwent 6 sessions of CBTi and a 1-month post-treatment follow up session. Data was collected at each treatment session as part of routine clinical care.ResultsA total of 69 US MHS beneficiaries seen at a TBI clinic with a diagnosis of insomnia began CBTi. Attrition rate at the end of the CBTi program and 1-month posttreatment session was 35% and 48%, respectively. Results demonstrated that sleep onset latency (SOL) and wake after sleep onset (WASO) decreased during treatment (p's < 0.001). Further, symptoms reported on the Insomnia Severity Index (ISI) improved during CBTi (p < 0.001).ConclusionFindings demonstrate how CBTi used in conjunction with a CBTi smartphone application can be used to effectively treat insomnia for MHS beneficiaries seeking care for TBIs. This evaluation provides the basis for further research on how CBTi may improve care within TBI programs. |
| first_indexed | 2024-03-08T22:03:07Z |
| format | Article |
| id | doaj.art-4254747e16aa4e6595af7f1129eb4f51 |
| institution | Directory Open Access Journal |
| issn | 2813-2890 |
| language | English |
| last_indexed | 2024-03-08T22:03:07Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Sleep |
| spelling | doaj.art-4254747e16aa4e6595af7f1129eb4f512023-12-19T10:43:26ZengFrontiers Media S.A.Frontiers in Sleep2813-28902023-12-01210.3389/frsle.2023.12689671268967Cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic: a quality improvement project assessing the integration of a smartphone application with behavioral treatmentJustin T. Matsuura0Nicole S. Keller1Michael B. Lustik2Carmen E. Campbell3Chad E. Grills4Department of Rehabilitation Services, Interdisciplinary Pain Management Center, Tripler Army Medical Center, Tripler AMC, HI, United StatesDepartment of Rehabilitation Services, Interdisciplinary Pain Management Center, Tripler Army Medical Center, Tripler AMC, HI, United StatesDepartment of Clinical Investigation, Tripler Army Medical Center, Tripler AMC, HI, United StatesDepartment of Clinical Investigation, Tripler Army Medical Center, Tripler AMC, HI, United StatesBrain Injury Clinic, Desmond T. Doss Health Clinic, Schofield Barracks, HI, United StatesObjectivesWhile the association between insomnia and traumatic brain injury (TBI) is well established, TBI rehabilitation programs that focus on sleep as a primary target are limited. Cognitive behavioral therapy for insomnia (CBTi) is an effective treatment for insomnia, however; its use within TBI clinics is relatively unknown. Therefore, our aim was to evaluate the implementation of CBTi, used in conjunction with a smartphone app for insomnia, within a US military TBI program to improve care within this setting.SettingA TBI clinic at a US military installation.MethodsMHS beneficiaries underwent 6 sessions of CBTi and a 1-month post-treatment follow up session. Data was collected at each treatment session as part of routine clinical care.ResultsA total of 69 US MHS beneficiaries seen at a TBI clinic with a diagnosis of insomnia began CBTi. Attrition rate at the end of the CBTi program and 1-month posttreatment session was 35% and 48%, respectively. Results demonstrated that sleep onset latency (SOL) and wake after sleep onset (WASO) decreased during treatment (p's < 0.001). Further, symptoms reported on the Insomnia Severity Index (ISI) improved during CBTi (p < 0.001).ConclusionFindings demonstrate how CBTi used in conjunction with a CBTi smartphone application can be used to effectively treat insomnia for MHS beneficiaries seeking care for TBIs. This evaluation provides the basis for further research on how CBTi may improve care within TBI programs.https://www.frontiersin.org/articles/10.3389/frsle.2023.1268967/fullinsomniabrain injuryUS military health system beneficiariescognitive behavioral therapysmartphone apprehabilitation |
| spellingShingle | Justin T. Matsuura Nicole S. Keller Michael B. Lustik Carmen E. Campbell Chad E. Grills Cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic: a quality improvement project assessing the integration of a smartphone application with behavioral treatment Frontiers in Sleep insomnia brain injury US military health system beneficiaries cognitive behavioral therapy smartphone app rehabilitation |
| title | Cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic: a quality improvement project assessing the integration of a smartphone application with behavioral treatment |
| title_full | Cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic: a quality improvement project assessing the integration of a smartphone application with behavioral treatment |
| title_fullStr | Cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic: a quality improvement project assessing the integration of a smartphone application with behavioral treatment |
| title_full_unstemmed | Cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic: a quality improvement project assessing the integration of a smartphone application with behavioral treatment |
| title_short | Cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic: a quality improvement project assessing the integration of a smartphone application with behavioral treatment |
| title_sort | cognitive behavioral therapy for insomnia in a military traumatic brain injury clinic a quality improvement project assessing the integration of a smartphone application with behavioral treatment |
| topic | insomnia brain injury US military health system beneficiaries cognitive behavioral therapy smartphone app rehabilitation |
| url | https://www.frontiersin.org/articles/10.3389/frsle.2023.1268967/full |
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