A short add-on sleep intervention in the rehabilitation of individuals with acquired brain injury: A randomized controlled trial.

The analysis included only the 41 people who finished the study, not all 54 who started, so the results may look better than the treatment really is. About a quarter of participants dropped out, four of them during the COVID-19 lockdowns, and the reasons for dropping out were not evenly spread across the two groups. Patients and therapists both knew who was receiving the extra treatment, and the researchers did not check whether people actually followed the sleep advice. Everyone was treated at a single rehabilitation centre in the Netherlands, and the sample is small. The three-month follow-up was done only in the treated group, because the waiting group was given the intervention after six weeks, so there is no comparison group for the long-term result. The short programme was never compared with a full-length course of CBT-I. All outcomes were self-report questionnaires; the study used no objective measure of sleep. Some sessions had to be delivered by video call because of the COVID-19 pandemic, which also disrupted the usual rehabilitation everyone was receiving.

The text supplied does not include a funding statement or a conflict of interest declaration, so it is not possible to say who paid for the study or what the authors declared.

Do not read this as the sleep programme fixing fatigue, anxiety or low mood. Those outcomes did not differ significantly between the groups; only sleep quality, sleep-related beliefs and coping with fatigue did. And the analysis covered only the 41 of 54 people who completed the study, so the benefit may be smaller among the patients who drop out of treatment in your clinic.