1387 Multimodal Treatment Including Acupuncture for Post-Traumatic Brain Injury Sleep Dysfunction: A Case Report
Abstract
Over 18% of American adults report prior traumatic brain injury (TBI), with the CDC reporting over 586 TBI-related hospitalizations per day. Research suggests that more than half of these patients experience sleep dysfunction, which jeopardizes their long term outcomes by limiting post-acute recovery. Treatment modalities such as CBT-I and melatonin are routinely employed for post-TBI sleep dysfunction, but compliance, patient preferences, and variation in the underlying cause of sleep dysfunction create a prominent risk for treatment failure. To alleviate this risk, we propose the use of a multimodal treatment plan that incorporates various well-tolerated treatment modalities along with acupuncture. We present a patient with post-TBI sleep dysfunction, successfully treated with a multimodal insomnia treatment plan.
A 33-year-old female one month post-rehabilitation for moderate TBI presented to an outpatient PM&R clinic with insomnia, difficulty initiating and maintaining sleep, nocturnal awakenings, and daytime fatigue. Treatment was initiated with an individualized multimodal plan including cognitive behavior therapy for insomnia (CBT-I), acupuncture, melatonin, light therapy, and structured sleep hygiene. CBT-I included in-person and online sessions. Acupuncture was used for sleep and mood support, while morning bright light, blue-wavelength light therapy, and melatonin (2-10 mg nightly for 4 weeks) were used to address circadian rhythm disruption. Sleep hygiene…
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