LIMBIC CENC LOGO

Long-Term Impact of Military-Relevant Brain Injury Consortium Chronic Effects of Neurotrauma Consortium

 Search LIMBIC CENC WEBSITE CONTENT Login If you do not have a LIMBIC-CENC website account please contact cencdbc@vcu.edu

Factors influencing shared decision-making for insomnia and obstructive sleep apnea treatment among veterans with mild traumatic brain injury

Kinney AR, Brenner LA, Nance M, Mignogna J, Cobb AD, Forster JE, Ulmer CS, Nakase-Richardson R, Bahraini NH. (2024). Factors influencing shared decision-making for insomnia and obstructive sleep apnea treatment among veterans with mild traumatic brain injury. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 10.5664/jcsm.10994. Advance online publication. https://doi.org/10.5664/jcsm.10994. PMID: 38189353.

Main Question

What are barriers and facilitators to implementing shared decision-making for Veterans with mTBI and sleep disorders?

Study Findings

Patient- and clinician-reported barriers to implementing shared decision-making were mTBI sequalae, de-prioritization of Veteran preferences, encounter time constraints, and reduced care access. Facilitators were enhanced trust, effective provider communication, and mitigating access barriers. Patients also reported provider discontinuity as a barrier.

Practical Uses

Our study revealed modifiable factors that shape shared decision-making in persons with mTBI and sleep disorders.

Clinicians should allow as much as possible sufficient time in encounters to build trust and prioritize Veterans’ treatment preferences. Clinicians should follow clinical practice guideline recommendations for promoting patient-centered care in sleep disorders.

For more information on assessing and managing sleep disorders

In an effort to provide the latest findings to our consumers as quickly as possible, some of these studies, while fully peer reviewed, have not been presented or published either electronically or in print. Findings are presented for informational purposes only and should not be cited or referenced until they are formally published or presented.

Virginia Commonwealth University is a nationally renowned public research institution dedicated to the success and well-being of all members of its community. VCU student, faculty and staff groups and associations are open without regard to any characteristic or identity protected by law.


The U.S. Army Medical Research Acquisition Activity, 839 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense, through the Psychological Health/Traumatic Brain Injury Research Program Long-Term Impact of Military-Relevant Brain Injury Consortium (LIMBIC) Award/W81XWH-18-PH/TBIRP-LIMBIC under Awards No. W81XWH1920067 and W81XWH-13-2-0095, and by the U.S. Department of Veterans Affairs Awards No. I01 CX002097, I01 CX002096, I01 HX003155, I01 RX003444, I01 RX003443, I01 RX003442, I01 CX001135, I01 CX001246, I01 RX001774, I01 RX 001135, I01 RX 002076, I01 RX 001880, I01 RX 002172, I01 RX 002173, I01 RX 002171, I01 RX 002174, and I01 RX 002170. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense. / Created by VCU University Relations

Skip to content