Insomnia following brain injury – is it worth treating?

Two papers published this month in sleep journals have looked at disturbances in sleep following brain injury.

In a meta-analysis published in Sleep Medicine Reviews, Kelsea Stewart et al. pooled data from 25 papers published on traumatic brain injury (TBI) and its effect on sleep.  30 to 70% of patients have affected sleep following TBI and it has been suggested that ongoing sleep problems may contribute to impaired recovery. The importance of treating sleep difficulties after TBI has been emphasised previously. Treatment effects were observed for insomnia, circadian rhythm disorders, hypersomnia, and general sleep disturbance.

 However there is conflicting evidence about the efficacyof treatment, and the authors suggest that further research is required.

In a separate randomised control trial published in the Journal of Sleep Research, Marthe Ford at al looked at the effect of online CBT specifically for insomnia following acquired brain injury including stroke, regardless of cognitive and psychiatric complaints.

This is an important area of medicine which is frequently neglected in the management of traumatic brain injury and stroke and requires much more attention. Online CBT has become a major player in the treatment of insomnia generally and should be considered for all patients including those where sleep has become deranged after a brain insult.

References:

Treating sleep disorders following traumatic brain injury in adults: Time for renewed effort?

Kelsea Stewart, Nicholas Shakarishvili, Adriana Michalak, Emily L Maschauer, Natalie Jenkins, Renata L Riha

Sleep Medicine Reviews 2022 April 14, 63: 101631

A blended eHealth intervention for insomnia following acquired brain injury: a randomised controlled trial

Marthe E Ford, Gert J Geurtsen, Erny Groet, Radha D Rambaran Mishre, Coen A M Van Bennekom, Eus J W Van Someren

Journal of Sleep Research 2022 May 31, : e13629