Can cognitive behavioral therapy for insomnia also treat fatigue, pain, and mood symptoms in individuals with traumatic brain injury? -- A multiple case report

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Article reviews the use of Cognitive Behavioral Therapy for Insomnia (CBT-I) for three participants with traumatic brain injuries (TBI) of different severities. CBT-I is a manualized treatment that effectively treats insomnia with secondary effects on cognition, mood, and pain in various populations. Pre- and post-treatment assessments of insomnia, fatigue, depression, anxiety, and pain were conducted. Mood was further assessed at follow-up. Minimal clinically important difference (MCID) scores derived from the research literature were used to establish clinically meaningful symptom improvement on self-report questionnaires. The reduction in insomnia severity scores for all three participants were not large enough to be considered a clinically significant improvement following CBT-I, although trends toward improvement were observed. However, all participants showed clinically significant reductions in anxiety at post-treatment; the effects persisted for 2 participants at follow-up. Reductions in depression symptoms were observed for 2 participants at post-treatment, and treatment effects persisted for 1 participant at follow-up. One participant endorsed clinically significant improvements in fatigue and pain severity. The authors conclude that CBT-I may provide secondary benefits for symptoms commonly experienced by individuals with TBI, especially mood disturbances.

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