Discussion
ABI, fatigue, anxiety, sleep disturbances, sleep-related cognitions, depressive
This randomized controlled trial (RCT) investigated the effectiveness of a short add-on CBT-I-based therapy for sleep disturbances in individuals with ABI in addition to rehabilitation treatment as usual. The CBT-I + TAU group improved more on self-reported sleep quality, dysfunctional beliefs and attitudes about sleep and partially on fatigue relative to the TAU only group. Specifically, the CBT-I + TAU group significantly improved on sleep quality with large effect sizes over time relative to the TAU only group. Furthermore, sleep-related cognitions significantly improved in the CBT-I + TAU group, with small effect sizes (ES = 0.375), as compared to the TAU only group, and participants in the CBT-I + TAU group were better able to cope with fatigue. No significant treatment effects were found regarding impact, consequences or symptoms of fatigue, mental and physical fatigue, or in anxiety and depressive symptoms. Our results also showed that the post-treatment improvement (e.g. sleep quality, sleep related cognitions and coping with fatigue) were maintained at 3-month follow-up in the group that received the add-on treatment.These results corroborate and extend previous findings showing that CBT is effective in improving sleep in individuals with ABI (