Promoting Restful Sleep in an Acute Inpatient Rehabilitation Hospital For Individuals With Acquired Brain Injury: A Feasibility Project

Abstract

<h3>Research Objectives</h3> To obtain preliminary data on the usefulness of audiobooks to promote sleep using objective measures <h3>Design</h3> Within-subjects design with two experimental conditions, one with audiobook and the other without. Participants were randomized into one of two groups counterbalanced for order. <h3>Setting</h3> Inpatient rehabilitation hospital. <h3>Participants</h3> 6 adults (3 males,3 females) with acquired brain injury (5 from stroke and 1 from brain tumor). Ages ranged from 33 to 72 (M=58.5, SD=13.9). <h3>Interventions</h3> Participants were monitored for sleep activity for 4 consecutive nights. For 2 consecutive nights, participants listened to an audiobook of their choice prior to bed using headphones. <h3>Main Outcome Measures</h3> Actigraph data (wrist-worn accelerometer) was analyzed to derive total sleep time. <h3>Results</h3> The audiobooks were well-tolerated by the participants. Repeated measures ANOVA taking order into account showed a significant overall effect of condition, F(1,4)=33.7, p=0.004 with a significant condition x order interaction, F(1,4)=21.8, p=0.010. The effect was much more exaggerated among those who were assigned to the audiobook on days 3 and 4 (phase 2), showing an average increase in total sleep time of 45 minutes. <h3>Conclusions</h3> Non-pharmacological sleep interventions are needed for patients with acquired brain injury to avoid the potential detrimental effects of medications. These findings are preliminary with a very small sample. However, examination of the data showed that five out of six participants showed an increase in total sleep time after using the audiobook before bedtime with the remaining participant showing very little change between conditions. Further study is needed to understand how audiobooks may serve as a non-pharmacological tool to help patients achieve better sleep in a hospital setting. <h3>Author(s) Disclosures</h3> Fire Tablet and titles were provided by Audible