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A Brief and Selective Review of Treatment Approaches for Sleep Disturbance following Traumatic Brain Injury

Mareen Weber, Christian A Webb and William DS Killgore

Sleep disturbance often presents as a clinically significant symptom of traumatic brain injury (TBI). Poor sleep may delay recovery, exacerbate psychiatric comorbidities, and even increase suicidal risk among patients with TBI. Thus, effective and efficient treatment of sleep disturbance in this population is critical. This review provides a brief, selective, and focused synopsis of several of the more common and empirically tested pharmacological and behavioral approaches and their efficacy in the treatment of sleep disturbance following TBI. Depending on the nature of the injury and the specific sleep-related problems, there may be appropriate uses for pharmacologic interventions such as hypnotic or wake-promoting agents, cognitive-behavioral therapy, sleep hygiene, circadian rhythm modification, or even alternative medicine approaches. Overall, the literature on this important topic is sparse, and existing studies are hampered by relatively small sample sizes, underrepresentation of youth and females, inconsistencies across reports in both time since injury and injury severity. Existing methodological limitations do not currently allow for definitive conclusions regarding the effectiveness of particular treatment approaches. Future research will not only need to address these limitations, but also develop treatment options for children and adolescents, who are currently underrepresented in the literature