# A Sleep Intervention to Improve Rehabilitation in Veterans with Chronic mTBI

> **NIH VA IK2** · PORTLAND VA MEDICAL CENTER · 2022 · —

## Abstract

Each year ~2.5 million people sustain a traumatic brain injury (TBI). Also a prominent general public health
issue, TBI is particularly prevalent in Veterans, with 60-80% reporting a history of TBI. Over 80% of all TBI are
categorized as mild TBI (mTBI), which is associated with a myriad of short- and long-term complications. Two
of the principal complicating factors associated with mTBI are sleep-wake disturbances (e.g., insomnia,
excessive daytime sleepiness, and circadian rhythm sleep disorders) and chronic pain, including headache
and diffuse/global pain. Sleep-wake disturbances and chronic pain have an independent prevalence of ~70%,
individually impair quality of life, impede effective rehabilitation, and have staggering economic impacts.
Furthermore, there is a strong bidirectional relationship between sleep-wake disturbances and pain such that
impaired sleep exacerbates pain, which leads to greater impairments in sleep and worse pain. This vicious
cycle between sleep disturbances and pain, which is a particularly prevalent and detrimental condition in
Veterans with chronic mTBI, represents a central challenge precluding effective treatment and ultimately,
improving Veteran quality of life. Although there are pharmacological and non-pharmacological therapies for
chronic pain, the presence of TBI significantly complicates the effectiveness of these treatment options, and
have significant adverse effects (e.g., long-term prescription opioid dependence, misuse, and overdose). We
believe there is profound potential to intervene at the sleep level, and, by improving sleep quality, enable
Veterans with chronic mTBI to better manage their pain and end this vicious cycle.
This proposal aims to apply a sleep intervention to improve chronic pain in Veterans with mTBI. We propose to
use morning bright light therapy (MBLT), a readily deployable, cost-effective, non-pharmacologic, and home-
based sleep intervention, to improve sleep-wake disturbances and therefore ameliorate chronic pain and
improve quality of life in Veterans with chronic mTBI. There is substantial scientific precedent for MBLT to be
effective in improving sleep quality, as outlined by a recent meta-analysis of 53 MBLT-based studies. Indeed,
the potential of MBLT to improve sleep quality in Veterans with chronic mTBI remains unexplored, and yet,
highly promising, especially in light of our exciting preliminary data supporting study feasibility and potential
effectiveness. Our central hypothesis is that MBLT will improve sleep quality and ameliorate pain, resulting in
improved quality of life in Veterans with chronic mTBI.
Specific aims designed to test our hypothesis are to determine the effect of MBLT on, 1) sleep, 2) pain, and 3)
quality of life, in Veterans with chronic mTBI. We propose to recruit n = 100 Veterans with mTBI from the VA
Portland Health Care System, randomized 1:1 to MBLT (10,000 lux light exposure for 30 min within 90 min of
waking for 4-weeks) or a no-light sham-MB...

## Key facts

- **NIH application ID:** 10396972
- **Project number:** 5IK2RX002947-04
- **Recipient organization:** PORTLAND VA MEDICAL CENTER
- **Principal Investigator:** Jonathan E Elliott
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10396972

## Citation

> US National Institutes of Health, RePORTER application 10396972, A Sleep Intervention to Improve Rehabilitation in Veterans with Chronic mTBI (5IK2RX002947-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10396972. Licensed CC0.

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