Kristen, Author at The Brain Injury Alliance of New Jersey

Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury

Summarized by Dan Zhou, MD
October 2023

Insomnia is one of the most common complaints after traumatic brain injury. It occurs in almost half of patients and is more common in those with mild injuries, also known as concussions. People with insomnia have difficulty falling and staying asleep at night. This can negatively affect day-to-day routines due to tiredness and difficulty concentrating. A recent article titled “Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury” was published in Frontiers in Neurology which reviews cognitive-behavioral therapy for insomnia (CBT-I) in concussion patients.

CBT-I uses a combined cognitive and behavioral approach to treatment. Some examples include concepts such as limiting stimulation at bedtime, relaxation training, cognitive therapy, and sleep hygiene training. The overall goal is to promote sleep at bedtime, improve the sleep/wake cycle, and address negative thoughts surrounding sleep which would decrease sleep-related anxiety and arousal. In treatment trials, CBT-I has emerged as the preferred treatment for insomnia. The article mentions that 70-80% of patients with insomnia experience lasting benefit from CBT-I and about half have complete resolution.

Similar to treating insomnia in general, CBT-I is also preferred as the main treatment for insomnia in concussion patients. Compared to taking prescription medications or self-treating, CBT-I does not have the side effects that all medications may carry and can provide lasting benefits. To understand why CBT-I is most appropriate for insomnia after concussion, we need to understand the connection between the two. The leading theory of why insomnia happens frequently after concussion is discussed in the article. First some people are at risk be it through their genetics or personalities. This is followed by a trigger which would be the head injury.

The last factor is the perpetuating loop that keeps the sleep issues going. This loop is due to changes in behavior and attitudes. For instance, some people may attempt to sleep longer by taking more naps during the day which can mess up normal sleep patterns. Additionally, having negative thoughts like “lack of sleep will negatively affect my recovery” causes a cycle of anxiety associated with sleep. It is specifically this perpetuating loop phase with all of its behavioral and emotional factors where CBT-I may have the greatest benefit. Improving sleep after concussion is important as it is shown to improve mental functioning, pain, depression, and anxiety. These are some of the reasons that CBT-I has been and remains promising for the treatment of insomnia in mild traumatic brain injury patients.


For more information, view the article:


Read more

Effects of Exercise Programs on Functional Capacity and Quality of Life in People With Acquired Brain Injury

Summarized by Meaghan Dowdell, SPT
August 2023

When someone experiences a brain injury, they may become more likely to lead a lifestyle with little physical activity, which can affect their independence and the things they enjoy doing, making life less fulfilling.

But, there’s good news! Taking part in a supervised exercise program after a brain injury can actually help improve both the physical and mental aspects of health. A study done in 2022 by Pérez-Rodríguez and colleagues looked at different types of exercises and how much people did them, finding out what helped the most for those with brain injuries.

They studied adults with brain injuries who did exercises like aerobics, strength training, or a mix of both for about 12 weeks. The exercises ranged from one to seven times a week, lasting between 30 to 120 minutes each time. They checked how these exercise programs affected things like balance, endurance, and mobility, as well as how people felt about themselves and their social interactions.

The big discovery was that no matter what type of exercise they did, those who stuck to the programs saw positive changes. It means that they improved in all those areas we mentioned before, which makes life better and more enjoyable after a brain injury.

So, it’s suggested that people with brain injuries should join supervised exercise programs that they can easily do and enjoy. Activities like walking, swimming, cycling, yoga, or weight lifting can be great choices. And having friends or family support you during these activities is a big plus!

Before starting any exercise program, it’s a good idea to check with a physical therapist or health care professional. They can make sure the exercises are safe and suitable for you and your goals. When you find exercises that you like and find important, it becomes easier to make them a part of your regular routine. This helps improve your life and health after a brain injury. 

 For more detailed information on the studies included in this review and the outcome measures performed, here is the link for the full article:   


Read more