0869 Morning Bright Light Improves Insomnia, Mood, And Pain In Veterans With TBI And PTSD

Abstract

Introduction: Insomnia is common among Veterans with Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD). This study sought to determine the effect of morning bright light therapy (MBLT) on sleep, mood, pain, and other quality of life measures in Veterans with and without TBI and PTSD. We also determined which factors best predicted response to MBLT. Methods: Self-report data was collected from n=45 Veterans (n=7 with TBI, n=10 with PTSD, n=10 with comorbid TBI+PTSD, and n=18 Controls) before and after 4-weeks of MBLT. Questionnaires included the Insomnia Severity Index (ISI), NIH PROMIS Pain surveys, Patient Health Questionnaire (PHQ-9), Neurobehavioral Sleep Inventory (NSI), Sleep Hygiene Index (SHI), and PTSD Checklist-5 (PCL-5). A Random Forest machine learning model predicting changes in ISI scores following MBLT was used to evaluate which variables were associated with response to therapy. Results: MBLT significantly improved ISI (P=0.007), PHQ-9 (P=0.049), PCL-5 (P=0.009), NSI (P=0.004), and pain (P=0.005) scores in TBI+PTSD subjects. Random Forest modelling found baseline ISI, SHI, NSI, PHQ-9, and pain symptoms to be the strongest predictors of response to MBLT. Both ISI (r=0.350; P=0.018) and SHI (r=0.336; P=0.030) were significantly correlated with response to MBLT. Surprisingly, the diagnosis of TBI and/or PTSD did not significantly affect response to MBLT. Conclusion: This study demonstrates the feasibility and potential for MBLT to improve insomnia, mood, and pain in Veterans, while also improving TBI- and PTSD-related symptoms. Random Forest predictive model analysis indicated that MBLT may have the strongest effect on those with severe insomnia and poor sleep hygiene at baseline, and is still effective in individuals carrying diagnoses of TBI and/or PTSD. These data highlight a potentially viable sleep intervention to improve sleep and quality of life in Veterans with TBI and PTSD.