Can people with poststroke insomnia benefit from blended cognitive behavioral therapy? A single case experimental design

TY - JOUR

T1 - Can people with poststroke insomnia benefit from blended cognitive behavioral therapy? A single case experimental design

AU - Ford, Marthe E.

AU - Geurtsen, Gert J.

AU - Schmand, Ben

AU - Groet, Erny

AU - Van Bennekom, Coen A.M.

AU - Van Someren, Eus J.W.

N1 - Funding Information: This study was supported by the Dutch Brain Foundation (Hersenstichting; Grant # DR2019-00337). Publisher Copyright: © 2022 The Author(s). Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment.

PY - 2023/12/31

Y1 - 2023/12/31

N2 - Purpose: Sleep is essential for our overall health and wellbeing. Unfortunately, stroke often induces insomnia, which has been shown to impede rehabilitation and recovery of function. Cognitive behavioral therapy for insomnia (CBT-I) is the treatment of choice for insomnia in the general population and is efficacious both when delivered face-to-face or online. The primary aim of this study was to evaluate efficacy of blended CBT-I (eCBT-I) in five poststroke participants with insomnia according to DSM-5 criteria. Methods: A randomized multiple baseline design was used to evaluate improvements in total sleep time, sleep onset latency, sleep efficiency, nocturnal awakenings and sleep quality. The intervention included six weeks of eCBT-I combined with two face-to-face sessions. Results: All participants completed the intervention. One participant stopped using the diary, while the other four completed it fully. All five sleep diary measures improved, significantly so for nocturnal awakenings. Moreover, after completion of the treatment, four out of five participants no longer fulfilled DSM-5 criteria for insomnia disorder Conclusions: This is the first study to show that blended CBT-I is potentially effective in participants with post-stroke insomnia. The findings justify extension to a randomized controlled trial.

AB - Purpose: Sleep is essential for our overall health and wellbeing. Unfortunately, stroke often induces insomnia, which has been shown to impede rehabilitation and recovery of function. Cognitive behavioral therapy for insomnia (CBT-I) is the treatment of choice for insomnia in the general population and is efficacious both when delivered face-to-face or online. The primary aim of this study was to evaluate efficacy of blended CBT-I (eCBT-I) in five poststroke participants with insomnia according to DSM-5 criteria. Methods: A randomized multiple baseline design was used to evaluate improvements in total sleep time, sleep onset latency, sleep efficiency, nocturnal awakenings and sleep quality. The intervention included six weeks of eCBT-I combined with two face-to-face sessions. Results: All participants completed the intervention. One participant stopped using the diary, while the other four completed it fully. All five sleep diary measures improved, significantly so for nocturnal awakenings. Moreover, after completion of the treatment, four out of five participants no longer fulfilled DSM-5 criteria for insomnia disorder Conclusions: This is the first study to show that blended CBT-I is potentially effective in participants with post-stroke insomnia. The findings justify extension to a randomized controlled trial.

KW - acquired brain injury

KW - cognitive behavioral therapy

KW - eHealth

KW - insomnia

KW - rehabilitation

KW - sleep

KW - stroke

U2 - 10.1017/BrImp.2022.12

DO - 10.1017/BrImp.2022.12

M3 - Article

AN - SCOPUS:85177860666

SN - 1443-9646

VL - 24

SP - 696

EP - 720

JO - Brain Impairment

JF - Brain Impairment

IS - 3

ER -