Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury
Mild traumatic brain injury (mTBI) is a significant public health problem. Insomnia is one of the most common symptoms of TBI, occurring in 30–50% of patients with TBI, and is more frequently reported in patients with mild as opposed to moderate or severe TBI. Although insomnia may be precipitated b...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-10-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.530273/full |
| _version_ | 1819093465432064000 |
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| author | Jessica R. Dietch Jessica R. Dietch Ansgar J. Furst Ansgar J. Furst Ansgar J. Furst Ansgar J. Furst |
| author_facet | Jessica R. Dietch Jessica R. Dietch Ansgar J. Furst Ansgar J. Furst Ansgar J. Furst Ansgar J. Furst |
| author_sort | Jessica R. Dietch |
| collection | DOAJ |
| description | Mild traumatic brain injury (mTBI) is a significant public health problem. Insomnia is one of the most common symptoms of TBI, occurring in 30–50% of patients with TBI, and is more frequently reported in patients with mild as opposed to moderate or severe TBI. Although insomnia may be precipitated by mTBI, it is unlikely to subside on its own without specific treatment even after symptoms of mTBI reduce or remit. Insomnia is a novel, highly modifiable treatment target in mTBI, treatment of which has the potential to make broad positive impacts on the symptoms and recovery following brain injury. Cognitive-behavioral therapy for insomnia (CBT-I) is the front-line intervention for insomnia and has demonstrated effectiveness across clinical trials; between 70 and 80% of patients with insomnia experience enduring benefit from CBT-I and about 50% experience clinical remission. Examining an existing model of the development of insomnia in the context of mTBI suggests CBT-I may be effective for insomnia initiated or exacerbated by sustaining a mTBI, but this hypothesis has yet to be tested via clinical trial. Thus, more research supporting the use of CBT-I in special populations such as mTBI is warranted. The current paper provides a background on existing evidence for using CBT-I in the context of TBI, raises key challenges, and suggests considerations for future directions including need for increased screening and assessment of sleep disorders in the context of TBI, examining efficacy of CBT-I in TBI, and exploring factors that impact dissemination and delivery of CBT-I in TBI. |
| first_indexed | 2024-12-21T23:11:57Z |
| format | Article |
| id | doaj.art-cd3063e250fc4b9aa5adf4754380b909 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-21T23:11:57Z |
| publishDate | 2020-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-cd3063e250fc4b9aa5adf4754380b9092022-12-21T18:47:01ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-10-011110.3389/fneur.2020.530273530273Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain InjuryJessica R. Dietch0Jessica R. Dietch1Ansgar J. Furst2Ansgar J. Furst3Ansgar J. Furst4Ansgar J. Furst5War Related Illness and Injury Study Center (WRIISC CA), VA Palo Alto Health Care System, Palo Alto, CA, United StatesDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United StatesWar Related Illness and Injury Study Center (WRIISC CA), VA Palo Alto Health Care System, Palo Alto, CA, United StatesDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United StatesDepartment of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, United StatesPolytrauma System of Care (PSC), VA Palo Alto Health Care System, Palo Alto, CA, United StatesMild traumatic brain injury (mTBI) is a significant public health problem. Insomnia is one of the most common symptoms of TBI, occurring in 30–50% of patients with TBI, and is more frequently reported in patients with mild as opposed to moderate or severe TBI. Although insomnia may be precipitated by mTBI, it is unlikely to subside on its own without specific treatment even after symptoms of mTBI reduce or remit. Insomnia is a novel, highly modifiable treatment target in mTBI, treatment of which has the potential to make broad positive impacts on the symptoms and recovery following brain injury. Cognitive-behavioral therapy for insomnia (CBT-I) is the front-line intervention for insomnia and has demonstrated effectiveness across clinical trials; between 70 and 80% of patients with insomnia experience enduring benefit from CBT-I and about 50% experience clinical remission. Examining an existing model of the development of insomnia in the context of mTBI suggests CBT-I may be effective for insomnia initiated or exacerbated by sustaining a mTBI, but this hypothesis has yet to be tested via clinical trial. Thus, more research supporting the use of CBT-I in special populations such as mTBI is warranted. The current paper provides a background on existing evidence for using CBT-I in the context of TBI, raises key challenges, and suggests considerations for future directions including need for increased screening and assessment of sleep disorders in the context of TBI, examining efficacy of CBT-I in TBI, and exploring factors that impact dissemination and delivery of CBT-I in TBI.https://www.frontiersin.org/article/10.3389/fneur.2020.530273/fullCBT (cognitive-behavioral therapy)insomniatraumatic brain injurymild traumatic brain injury (mTBI)sleepcognitive behavioral therapy for insomnia (CBT-I) |
| spellingShingle | Jessica R. Dietch Jessica R. Dietch Ansgar J. Furst Ansgar J. Furst Ansgar J. Furst Ansgar J. Furst Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury Frontiers in Neurology CBT (cognitive-behavioral therapy) insomnia traumatic brain injury mild traumatic brain injury (mTBI) sleep cognitive behavioral therapy for insomnia (CBT-I) |
| title | Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury |
| title_full | Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury |
| title_fullStr | Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury |
| title_full_unstemmed | Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury |
| title_short | Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury |
| title_sort | perspective cognitive behavioral therapy for insomnia is a promising intervention for mild traumatic brain injury |
| topic | CBT (cognitive-behavioral therapy) insomnia traumatic brain injury mild traumatic brain injury (mTBI) sleep cognitive behavioral therapy for insomnia (CBT-I) |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.530273/full |
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