Cognitive Behavioral Therapy for Insomnia as Treatment for Post-Concussive Symptoms

¹Mental Health Department, VA Ann Arbor Healthcare System, USA
²Department of Psychiatry, University of Michigan Health System, USA
³Department of Ambulatory Care, VA Ann Arbor Healthcare System, USA        

^*Corresponding Author: Robert J Spencer, Ph.D., Ann Arbor VA Healthcare System, Mental Health (116B), 2215 Fuller Road, Ann Arbor, MI 48105, USA.

Received: October 29, 2019
Published: November 14, 2019

ABSTRACT

Postconcussive symptoms (PCS) are frequently reported in those who have sustained a traumatic brain injury and there are few evidence-based treatments available following the acute recovery phase. PCS includes a range of symptoms, and therefore, rehabilitation has focused more broadly on cognitive, emotional, and/or physical complaints. A common presentation with PCS is sleep concerns or insomnia, which may represent a more definitive cluster of symptoms for treatment interventions to target and enhance recovery. At present, little is known about the impact of treating sleep concerns on the expression of PCS. Therefore, the current study examined the degree to which PCS improved with treatment focused on insomnia, specifically Cognitive Behavioral Therapy for Insomnia (CBTI). In a primary care setting, thirty Veterans seeking treatment for insomnia completed measures of PCS, mood, and sleep-related variables both before and after CBTI treatment. Results suggested statistically significant and clinically meaningful improvements in PCS symptoms, depression and anxiety, and sleep-related variables in the whole sample and among those with a history of TBI. Important reductions with sleep medication were observed as well. Given these findings, targeting insomnia may represent an important focus for interventions to enhance longer-term recovery in TBI populations.

Keywords: Insomnia, Military, Traumatic Brain Injury, Veterans