Telephone problem-solving treatment improves sleep quality in service members with combat-related mild traumatic brain injury: Results from a randomized clinical trial

S. Vuletic, K. R. Bell, S. Jain, N. Bush, N. Temkin, J. R. Fann, K. E. Stanfill, S. Dikmen, J. A. Brockway, F. He, K. Ernstrom, R. Raman, G. Grant, M. B. Stein, G. A. Gahm

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Objective: Evaluate sleep quality, its correlates, and the effect of telephone-based problem-solving treatment (PST) in active duty postdeployment service members with mild traumatic brain injury (mTBI). Setting: Randomized clinical trial. Participants: Active duty service members with combat-related mTBI. Study design: Education-only (EO) and PST groups (N = 178 each) received printed study materials and 12 educational brochures. The PST group additionally received up to 12 PST telephone calls addressing participant-selected issues. Outcomes were evaluated postintervention (6 months) and at 12 months. Main Measure: Pittsburgh Sleep Quality Index. Results: Sleep quality was manifestly poor in both groups at baseline (Pittsburgh Sleep Quality Index = 12.5 ± 4). Overall sleep quality was significantly different between the PST and EO groups at 6 months (P =.003) but not at 12 months. Longitudinally, PST significantly improved sleep quality at 6 months (P =.001) but not over the follow-up. Low sleep quality was associated with concussion symptoms, pain, depression, and posttraumatic stress disorder at all time points (P <.0001). Conclusions: Sleep disorders, common in postdeployment service members with mTBI, are strongly associated with the presence of pain, posttraumatic stress disorder, and depression. Telephone-based PST may be an effective therapeutic approach for reducing sleep disorders in this population. Research should focus on maintenance of treatment gains.

Original languageEnglish (US)
Pages (from-to)147-157
Number of pages11
JournalJournal of Head Trauma Rehabilitation
Volume31
Issue number2
DOIs
StatePublished - Mar 4 2016

Keywords

  • Insomnia
  • Military
  • Problem-solving treatment
  • Sleep
  • Traumatic brain injury

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

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    Vuletic, S., Bell, K. R., Jain, S., Bush, N., Temkin, N., Fann, J. R., Stanfill, K. E., Dikmen, S., Brockway, J. A., He, F., Ernstrom, K., Raman, R., Grant, G., Stein, M. B., & Gahm, G. A. (2016). Telephone problem-solving treatment improves sleep quality in service members with combat-related mild traumatic brain injury: Results from a randomized clinical trial. Journal of Head Trauma Rehabilitation, 31(2), 147-157. https://doi.org/10.1097/HTR.0000000000000221