TY - JOUR
T1 - A blended eHealth intervention for insomnia following acquired brain injury: a randomised controlled trial
T2 - a randomised controlled trial
AU - Ford, M.E
AU - Geurtsen, G.J.
AU - Groet, E.
AU - Rambaran Mishre, R.D.
AU - Van Bennekom, C.A.M.
AU - Van Someren, E.J.W.
N1 - With supplementary file
PY - 2023/2
Y1 - 2023/2
N2 - The high prevalence and severe consequences of poor sleep following acquired brain injury emphasises the need for an effective treatment. However, treatment studies are scarce. The present study evaluates the efficacy of blended online cognitive behavioural therapy for insomnia (eCBT-I) developed specifically for people with acquired brain injury. In a multicentre prospective, open-label, blinded end-point randomised clinical trial, 52 participants with insomnia and a history of a stroke or traumatic brain injury were randomised to 6 weeks of guided eCBT-I or treatment as usual, with a 6-week follow-up. The primary outcome measure was the change in insomnia severity between baseline and after treatment, measured with the Insomnia Severity Index. Results showed that insomnia severity improved significantly more with eCBT-I than with treatment as usual compared to baseline, both at post-treatment (mean [SEM] 4.0 [1.3] insomnia severity index points stronger decrease, d = 0.96, p < 0.003) and at follow-up (mean [SEM] 3.2 [1.5] insomnia severity index points, d = -0.78, p < 0.03). In conclusion, our randomised clinical trial shows that blended CBT is an effective treatment for insomnia, and feasible for people with acquired brain injury, regardless of cognitive and psychiatric complaints. Online treatment has major advantages in terms of availability and cost and may contribute to the successful implementation of insomnia treatment for people with acquired brain injuries.
AB - The high prevalence and severe consequences of poor sleep following acquired brain injury emphasises the need for an effective treatment. However, treatment studies are scarce. The present study evaluates the efficacy of blended online cognitive behavioural therapy for insomnia (eCBT-I) developed specifically for people with acquired brain injury. In a multicentre prospective, open-label, blinded end-point randomised clinical trial, 52 participants with insomnia and a history of a stroke or traumatic brain injury were randomised to 6 weeks of guided eCBT-I or treatment as usual, with a 6-week follow-up. The primary outcome measure was the change in insomnia severity between baseline and after treatment, measured with the Insomnia Severity Index. Results showed that insomnia severity improved significantly more with eCBT-I than with treatment as usual compared to baseline, both at post-treatment (mean [SEM] 4.0 [1.3] insomnia severity index points stronger decrease, d = 0.96, p < 0.003) and at follow-up (mean [SEM] 3.2 [1.5] insomnia severity index points, d = -0.78, p < 0.03). In conclusion, our randomised clinical trial shows that blended CBT is an effective treatment for insomnia, and feasible for people with acquired brain injury, regardless of cognitive and psychiatric complaints. Online treatment has major advantages in terms of availability and cost and may contribute to the successful implementation of insomnia treatment for people with acquired brain injuries.
KW - Brain Injuries/complications
KW - Cognitive Behavioral Therapy/methods
KW - Humans
KW - Prospective Studies
KW - Sleep Initiation and Maintenance Disorders/etiology
KW - Telemedicine
KW - Treatment Outcome
KW - brain injuries
KW - cognitive behavioural therapy
KW - sleep
KW - stroke
KW - traumatic
UR - https://pure.uva.nl/ws/files/121247019/jsr13629_sup_0001_tables.docx
UR - http://www.scopus.com/inward/record.url?scp=85130990077&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85130990077&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/jsr.13629
DO - https://doi.org/10.1111/jsr.13629
M3 - Article
C2 - 35641443
SN - 0962-1105
VL - 32
SP - 1
EP - 9
JO - Journal of sleep research
JF - Journal of sleep research
IS - 1
M1 - e13629
ER -