A Sleep Intervention to Improve Quality of Life and Symptom Management in Veterans With the Polytrauma Clinical Triad
VA Office of Research and Development
Summary
The "polytrauma clinical triad" (PCT), a highly disabling constellation of factors, is defined by the coexistence of traumatic brain injury, post-traumatic stress disorder, and chronic pain. Veterans with the PCT are medically complex, often refractory to conventional therapies, and suffer from additional related chronic sequela. Notably, sleep disturbances and cognitive impairment, which the investigators hypothesize are significant contributing factors to these functional impairments and an impediment toward rehabilitation. Thus, the investigators' research aims to intervene "at the level of sleep", and by improving sleep, improve these interconnected, disabling, and difficult to treat enduring complexities associated with the PCT - ultimately to improve Veteran quality of life, functional independence, and restorative function. The investigators predict that the proposed intervention, morning bright light therapy, which is cost-effective, rapidly deployable and home-based, will be effective in improving sleep and overall PCT symptom management, thereby, resulting in a measurable and impactful improvement in quality of life.
Description
The co-existence of traumatic brain injury, post-traumatic stress disorder (PTSD), and chronic pain defines the clinical entity referred to as the "polytrauma clinical triad" (PCT). Well recognized to be highly prevalent and disabling in US military service members and Veterans, those with the PCT are traditionally viewed as the most disabled cases and most refractory to conventional therapies. Central to the challenge in effectively treating Veterans with the PCT is the bi-directional, mutually reinforcing relationship between these conditions. Further complicating is the influence of sleep a…
Eligibility
- Age range
- 18–89 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Veteran * English speaking with phone and internet access * Current self-reported sleep disturbances * Clinical stable for current pharmacologic or behavioral health treatments for depression, anxiety, sleep and pain * Documented history of TBI Exclusion Criteria: * Decisional impairment and/or dementia * Current usage of a lightbox or negative ion generator * Shift work * History of macular degeneration and/or bipolar disorder * Evidence for suicidal ideation * Cancer diagnosis within the past 6 months * Surgery within the past 6 months * Substance abuse within the pa…
Interventions
- DeviceMorning Bright Light Therapy
Morning bright light: Sitting in front of a lightbox for 60 minutes every morning within 120 minutes of waking up.
- DeviceNegative Ion Generator
Negative ion generator: Sitting in front of a modified negative ion generator for 60 min every morning within 120 minutes of waking up.
Location
- VA Portland Health Care System, Portland, ORPortland, Oregon