Evidence map›Paper›PMID 39749423›Full record

Trial reportJournal of rehabilitation medicine2025

Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury.

Lucy Ymer, Adam McKay, Dana Wong, Kate Frencham, Natalie Grima, Monique Roper, Sylvia Nguyen, Jade Murray, Gershon Spitz, Jennie Ponsford

Abstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of rehabilitation medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lucy YmerMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.
Adam McKayMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Epworth Healthcare, Melbourne, VIC, Australia.
Dana WongMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
Kate FrenchamMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.
Natalie GrimaMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.
Monique RoperMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.
Sylvia NguyenEpworth Healthcare, Melbourne, VIC, Australia.
Jade MurrayMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.
Gershon SpitzMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.
Jennie PonsfordMonash Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia; Epworth Healthcare, Melbourne, VIC, Australia. jennie.ponsford@monash.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveEvaluate efficacy of cognitive behavioural therapy for sleep and fatigue adapted for brain injury relative to health education control in alleviating sleep disturbance and fatigue after acquired brain injury.

designParallel groups randomized controlled trial. SUBJECTS: 126 community dwelling adults with stroke or traumatic brain injury.

methodsParticipants were randomized 2:1 to receive 8-weeks of cognitive behavioural therapy for sleep and fatigue (n = 86) or health education (n = 40). The Pittsburgh Sleep Quality Index was assessed pre- and post-treatment, and 2 and 4-months post-treatment, with secondary measures of insomnia, fatigue, sleepiness, mood, quality of life, activity levels, self-efficacy, and actigraphy.

resultsBoth groups showed improved sleep by 4-month follow-up. However, cognitive behavioural therapy for sleep and fatigue had significantly larger and more rapid improvements than health education immediately post-treatment (β = -1.50, p < 0.001, 95% confidence interval -2.35 to -0.64). There were no significant between-groups differences in fatigue; however, cognitive behavioural therapy for sleep and fatigue showed within-group gains on both fatigue measures immediately post-treatment and over time (β = -0.29, p = 0.047, 95% confidence interval -0.58 to -0.01). Health education had delayed improvements at 4-month follow-up on 1 fatigue measure.

conclusionsBoth cognitive behavioural therapy for sleep and fatigue and health education led to improvement in sleep and fatigue; however, effects were larger and more rapid for cognitive behavioural therapy for sleep and fatigue immediately post-treatment. This supports the efficacy of cognitive behavioural therapy for sleep and fatigue in acquired brain injury but also highlights that health education may result in delayed improvements in symptoms. ANZCTR Trial registration numbers: 1261700087830; 12617000879369.

Indexed as

Brain Injuries, TraumaticCognitive Behavioral TherapyFatigueHealth EducationSleep Wake DisordersStrokeAdultAgedFemaleHumansMaleMiddle AgedQuality of LifeStroke RehabilitationTreatment Outcome

Identifiers

PMID39749423
PMCPMC11681142

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.