By Dr. Henry Orff

UnSplash Photo

The recent conflicts in Iraq and Afghanistan have brought much needed attention to Traumatic Brain injury (TBI), which occurs in about 19.5% of deployed service members. For many Veterans, mild traumatic brain injury (mTBI) can be associated with many symptoms that persist after injury such as depression, headaches, dizziness, tinnitus, fatigue, trouble with concentration, mood shifts, behavioral changes, seizures, and especially sleep disturbances. In fact, sleep disturbances are among the most frequent complaints following mTBI, with studies suggesting that over 93% of Veterans who experienced brain injuries develop chronic sleep problems. The most common sleep disturbance is insomnia, which is seen in over half of patients with mTBI. Left untreated, chronic insomnia is known to be associated with increased risk for psychiatric problems, suicidal ideation, and unhealthy lifestyles (e.g., alcohol/drug abuse), and may lead to poorer physical health, disruption in major social and occupational responsibilities, and decreased quality of life.  Chronic insomnia may even contribute to the persistence of symptoms related to TBI beyond the expected period of recovery (see: doi:10.4172/2325-9639.1000153). Treatment of sleep disturbance therefore is critically important for Veterans with a history of mTBI who commonly present with additional problems such as PTSD and depression.

Although many effective treatments for problems like PTSD and depression have been developed, research has shown that sleep rarely improves from these treatments alone, leading to poorer long-term functioning and risk for symptom relapse. On the other hand, research does suggest that Cognitive-Behavioral Therapy for Insomnia (CBT-I), may actually lead to improvements in both sleep and other comorbid psychiatric symptoms.  Dr. Henry Orff, a CESAMH researcher, reasoned that the treatment of sleep may help Veterans with mTBI not only sleep better but also may improve other mTBI symptoms.   CBT-I could be an effective “first-line” intervention for Veterans with history of mTBI who experience this comorbid symptomatology.

To further explore the importance of treating insomnia in Veterans with a history of mTBI, Dr. Orff, is conducting an investigation comparing CBT-I to a sleep education program, with a goal of evaluating the effectiveness of CBT-I in improving sleep, mental/physical health, and quality of life in Veterans.