Article

OBJECTIVE: To explore feasibility and potential efficacy of on-line interventions
for sleep quality following a traumatic brain injury (TBI). DESIGN: A two
parallel-group, randomized controlled pilot study.
SETTING: Community-based.
SUBJECTS: In all, 24 participants (mean age: 35.9 +/- 11.8 years) who reported
experiencing sleep difficulties between 3 and 36 months after a mild or moderate TBI. INTERVENTIONS: Participants were randomized to receive either a cognitive
behaviour therapy or an education intervention on-line. Both interventions were
self-completed for 20-30 minutes per week over a six-week period. MAIN MEASURES:
The Pittsburgh Sleep Quality Index assessed self-reported sleep quality with
actigraphy used as an objective measure of sleep quality. The CNS Vital Signs
on-line neuropsychological test assessed cognitive functioning and the Rivermead
Post-concussion Symptoms and Quality of Life after Brain Injury questionnaires
were completed pre and post intervention. RESULTS: Both programmes demonstrated
feasibility for use post TBI, with 83.3% of participants completing the
interventions. The cognitive behaviour therapy group experienced significant
reductions ( F = 5.47, p = 0.04) in sleep disturbance (mean individual change =
-4.00) in comparison to controls post intervention (mean individual change =
-1.50) with a moderate effect size of 1.17. There were no significant group
differences on objective sleep quality, cognitive functioning, post-concussion
symptoms or quality of life. CONCLUSION: On-line programmes designed to improve
sleep are feasible for use for adults following mild-to-moderate TBI. Based on
the effect size identified in this pilot study, 128 people
(64 per group) would
be needed to determine clinical effectiveness.

Langue : ANGLAIS