0473 Effects of Brief Behavioral Treatment for Insomnia in Traumatic Brain Injury Survivors: A Randomized Controlled Trial

Abstract Introduction Insomnia is a common and persistent problem among individuals with traumatic brain injury (TBI), often exacerbating cognitive and emotional difficulties. Brief Behavioral Treatment for Insomnia (BBTi) has demonstrated efficacy across various populations; however, it has not yet been evaluated in patients with TBI. This study aimed to examine the effects of BBTi on sleep and related outcomes in adults with TBI-related insomnia. Methods An assessor-blinded, three-arm, parallel-group randomized controlled trial was conducted with 93 TBI survivors presenting with insomnia symptoms. Participants were randomly assigned (1:1:1) to a nurse-guided BBTi group, a mobile-delivered BBTi app group, or a sleep hygiene control group. The nurse-guided BBTi involved a four-week program comprising two in-person and two telephone sessions focusing on sleep hygiene, stimulus control, sleep restriction, and relaxation techniques. The mobile BBTi group received equivalent content through an application integrating Sleep Aids, My Sleep, and Sleep Reminder functions. The control group received usual care, sleep hygiene education, and weekly LINE contact. Primary outcomes were sleep parameters measured using the Chinese versions of the Insomnia Severity Index, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index, along with seven-day actigraphy and sleep diaries. Secondary outcomes included mood and cognitive performance, assessed with the Hospital Anxiety and Depression Scales. Data were collected at baseline, post-treatment, and six- and twelve-month follow-ups, and analyzed using generalized estimating equations. Results All 93 participants completed the study. Compared with the control group, both BBTi interventions significantly reduced wake after sleep onset (WASO) and improved sleep efficiency at follow-up (all p < .05). The mobile BBTi group showed earlier improvements in WASO at T1 and T3. Conclusion Both face-to-face and mobile-delivered BBTi interventions significantly improved sleep outcomes among TBI survivors. The mobile BBTi demonstrated efficacy comparable to nurse-guided BBTi, highlighting its potential as a scalable, accessible approach for managing post-TBI insomnia. Support (if any)