CBT Improves Sleep Outcomes in Acquired Brain Injury

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CBT Improves Sleep Outcomes in Acquired Brain Injury

Cognitive behavioral therapy significantly improves sleep disturbances in adults with acquired brain injury, with benefits observed in sleep quality, insomnia severity, and sleep efficiency. Cognitive behavioral therapy (CBT) may improve sleep disturbances among individuals with acquired brain injury, according to study findings published in Sleep Medicine Sleep disturbances are common among individuals with acquired brain injury — including those recovering from traumatic brain injury or stroke — and may negatively affect recovery and quality of life. Researchers conducted a systematic review and meta-analysis assessing the effect of CBT-based interventions on sleep disturbances following acquired brain injury. Overall, CBT offers multidimensional therapeutic benefits for sleep disturbances, enhancing both subjective sleep perception and the efficiency of sleep architecture. Eligible studies enrolled adults aged 18 years and older with a diagnosis of acquired brain injury who experienced sleep disturbances. Participants in the intervention groups received CBT-based therapies, incorporating components such as sleep hygiene education, stimulus control, sleep restriction, cognitive restructuring, and relaxation techniques. Participants in the control groups received usual care or health education. Sleep-related outcomes included measures such as sleep quality, insomnia severity, and objective sleep parameters. A total of 8 randomized controlled trials were included in the meta-analysis, representing a combined sample of 387 participants. The included studies were published between 2017 and 2025. Across the included trials, intervention durations ranged from 6 to 9 weeks. According to pooled analyses, CBT was associated with significant improvements in overall sleep outcomes among individuals with acquired brain injury (standardized mean difference [SMD], −0.95; 95% CI, −1.47 to −0.43;P=.0003). Further analyses examining specific sleep domains demonstrated that CBT significantly improved subjective sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI; mean difference [MD], −2.34; 95% CI, −3.23 to −1.45;P<.00001). In addition, CBT significantly reduced insomnia severity scores on the Insomnia Severity Index (ISI; MD, −3.46; 95% CI, −4.27 to −2.64; P <.00001), suggesting a meaningful reduction in insomnia symptoms among individuals receiving CBT-based interventions. CBT was also associated with a statistically significant improvement in sleep efficiency (SMD, −0.38; 95% CI, −0.67 to −0.09;P=.01). Subgroup analyses demonstrated that traditional face-to-face CBT and electronically delivered CBT were associated with significant improvements in sleep outcomes. No statistically significant differences in treatment efficacy were observed between these modalities. Study limitations include the relatively small number of randomized trials, limited sample sizes, and reliance on self-reported sleep outcomes. In addition, variability in intervention intensity and control conditions across studies may have contributed to heterogeneity in the pooled results. “Overall, CBT offers multidimensional therapeutic benefits for sleep disturbances, enhancing both subjective sleep perception and the efficiency of sleep architecture,” the researchers concluded. Disclosures: This research was supported by the National Natural Science Foundation of China and Guizhou Province Traditional Chinese Medicine Project. Please see the original reference for a full list of disclosures. References:Zhu H, Wen Q, Zhang F, Li S, Wang X, Li J. The efficacy of cognitive behavioral therapy for sleep disorders following acquired brain injury: a systematic review and meta-analysis. Sleep Med. 2026;138:108678. doi:10.1016/j.sleep.2025.108678