In a small randomized prospective study presented at SLEEP2019 in San Antonio, TX, mindfulness-based stress reduction (MBSR) was more effective than usual care for the treatment of insomnia in individuals with traumatic brain injury (TBI). After 8 weeks of treatment, participants with brain injury who received MBSR (N=10, enrollment ongoing) had significantly greater improvements in insomnia severity scores compared with usual treatment (-5.1; CI -1.4 to -7.3; P = .047). No statistically significant changes in Fatigue Severity Scale (FSS), Perceived Stress Scale (PSS) or Personal Health Quality scores were seen, however. Objective measures did not show statistical differences including sleep efficiency or total sleep time.
Treatment with MBSR may be an effective nonpharmacologic therapy that has the potential to become a preferred treatment for patients with mild to moderate TBI and symptoms of chronic insomnia, which is present in over 70% of people with TBI. Cognitive behavioral therapy for insomnia has been tested in small studies in veterans with TBI, however, this often fails to address comorbid posttraumatic stress disorder (PTSD) or pain. An internationally standardized protocol, MBSR has been shown to reduce insomnia and chronic pain in recent studies in civilians, and reduce PTSD symptoms in veterans with TBI.
These data were presented at SLEEP2019, the 33rd annual meeting of the Associated Professional Sleep Societies LLC (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.
Chengyuan Wu, MD, MSBmE
William Renthal, MD, PhD