What Researchers Did
Researchers conducted a systematic review and meta-analysis of randomized controlled trials to evaluate non-pharmacologic therapies for sleep disturbances after traumatic brain injury.
What They Found
Cognitive behavioural therapy (CBT) significantly improved sleep quality (PSQI by -3.44), insomnia severity (ISI by -2.23 at 6-8 weeks and -0.91 at 12-16 weeks), and daytime sleepiness (ESS by -1.45 at 16 weeks). Only the improvement in sleep quality met a clinically important difference. For hyperbaric oxygen therapy (HBOT), blue-wavelength light therapy, and repetitive transcranial magnetic stimulation, the evidence was very low, and HBOT showed a higher risk of mild ear barotrauma compared to sham (relative risk: 2.66).
What This Means for Canadian Patients
Canadian patients experiencing sleep disturbances after a traumatic brain injury may find cognitive behavioural therapy (CBT) to be a beneficial non-pharmacologic treatment option. The study found very limited evidence to support hyperbaric oxygen therapy (HBOT) for improving sleep outcomes in this population, and noted a risk of mild ear barotrauma with HBOT. Patients should discuss these findings with their healthcare providers to determine the most appropriate treatment plan.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
The study's main limitation for hyperbaric oxygen therapy, blue-wavelength light therapy, and repetitive transcranial magnetic stimulation was the very low quality of evidence due to small sample sizes and varied study designs.