Abstract Details

Title Mindfulness Based Stress Reduction as a treatment for Chronic Insomnia in Traumatic Brain Injury Patients

Topic Sleep

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-023

Objective Determine if the Mindfulness-Based Stress Reduction is effective in reducing chronic insomnia in Traumatic Brain Injury patients.

Background Chronic insomnia is experienced by over 70% of service members with traumatic brain injury (TBI), and limited evidence guides the therapy decisions of current usual care. Ineffective medications are often prescribed, yielding only dangerous side effects. Cognitive behavioral therapy for insomnia has been tested in small studies in TBI veterans, but it may fail to address typical comorbidities such as PTSD and chronic pain. Mindfulness Based Stress Reduction (MBSR) –an internationally standardized protocol, has been shown to reduce insomnia and chronic pain in recent studies in civilians, and reduce PTSD symptoms in veterans with TBI. However, its effectiveness on treating chronic insomnia in TBI patients has not yet been evaluated.

Design/Methods A prospective, randomized trial with 1:1 randomization to usual care versus MBSR. The primary endpoint is a reduction of the Insomnia Severity Index (ISI) after eight weeks of MBSR group therapy. Several secondary endpoints have been identified, including ISI scores at six months (results pending), fatigue severity scale (FSS), perceived stress scale (PSS), and PHQ-9 scales, total sleep time and sleep efficiency as measured by actigraphy watch. Outcomes scores were compared with the Student’s T test.

Results Subjects receiving MBSR (N=10) had an average improved ISI by -5.1 (95% CI -1.4 to -8.3) compared to -1.4 (95% CI -5.3 to 1). No statistical significant change in FSS, PSS, or PHQ-9 was noted. Objective measures show no statistical difference (sleep efficiency, total sleep time).

Conclusions MBSR has the potential to become a preferred adjunct method of treatment for patients with mild to moderate TBI in order to alleviate the symptoms of chronic insomnia.

Authors/Disclosures
J. Kent Werner, Jr., MD, PhD (Uniformed Services University) PRESENTER	Dr. Werner has received personal compensation for serving as an employee of Cogentis Therapeutics. Dr. Werner has stock in Cogentis Therapeutics. Dr. Werner has received intellectual property interests from a discovery or technology relating to health care. Dr. Werner has received intellectual property interests from a discovery or technology relating to health care. Dr. Werner has received personal compensation in the range of $100,000-$499,999 for serving as a Neurologist with United States Navy. Dr. Werner has received personal compensation in the range of $50,000-$99,999 for serving as a CEO / CoFounder with Cogentis Therapeutics.

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