Telephone Problem-Solving Treatment Improves Sleep Quality in Service Members With Combat-Related Mild Traumatic Brain Injury

Authors:
  • SVS. Vuletic
    S. Vuletic
  • SJS. Jain
    S. Jain
  • NTN. Temkin
    N. Temkin
  • JFJ. R. Fann
    J. R. Fann
  • KSK. E. Stanfill
    K. E. Stanfill
  • SDS. Dikmen
    S. Dikmen
  • JBJ. A. Brockway
    J. A. Brockway
  • FHF. He
    F. He
  • KEK. Ernstrom
    K. Ernstrom
  • RRR. Raman
    R. Raman
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Abstract
Evaluate sleep quality, its correlates, and the effect of telephone-based problem-solving treatment (PST) in active duty postdeployment service members with mild traumatic brain injury (mTBI) Randomized clinical trial. Active duty service members with combat-related mTBI. Education-only (EO) and PST groups (N = 178 each) received printed study materials and 12 educational brochures. The PST group additionally received up to 12 PST telephone calls addressing participant-selected issues. Outcomes were evaluated postintervention (6 months) and at 12 months. Pittsburgh Sleep Quality Index. Sleep quality was manifestly poor in both groups at baseline (Pittsburgh Sleep Quality Index = 12.5 ± 4). Overall sleep quality was significantly different between the PST and EO groups at 6 months (P = .003) but not at 12 months. Longitudinally, PST significantly improved sleep quality at 6 months (P = .001) but not over the follow-up. Low sleep quality was associated with concussion symptoms, pain, depression, and posttraumatic stress disorder at all time points (P < .0001). Sleep disorders, common in postdeployment service members with mTBI, are strongly associated with the presence of pain, posttraumatic stress disorder, and depression. Telephone-based PST may be an effective therapeutic approach for reducing sleep disorders in this population. Research should focus on maintenance of treatment gains.

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