Cognitive Behavioral Therapy Improves Insomnia from Chronic Pain

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Cognitive behavioral therapies may be effective in treating insomnia in patients with chronic pain, according to research published in the journal Sleep.

Nicole Tang, DPhil, CPsychol, from the Department of Psychology at the University of Warwick and colleagues found that cognitive behavioral therapies (CBT) were moderately or strongly effective in treating insomnia in patients with long-term pain. They found that patients also experienced benefits to pain, fatigue, and depression. However, the therapies reviewed needed to be administered in person to be effective; therapies delivered online or by phone were found to be less effective.

To examine the effects of non-drug treatments for insomnia in patients with chronic pain, the researchers examined 72 studies containing a total of 1066 patients ages 45-61 who experienced insomnia and chronic pain caused by a variety of conditions including long-term cancer, headaches, and arthritis.

They found that the most popular treatments covered a variety of approaches including psycho-education about sleep hygiene (good sleeping habits such as a regular sleeping pattern), stimulus control, sleep restriction, and cognitive therapy.

In addition to improved sleep, the researchers found that patients experienced a mild to moderate decrease in pain immediately after therapy, and that improved sleep reduced depression following treatment and at follow-ups up to 12 months.

The researchers believe that this highlights the need to treat insomnia stemming from chronic pain as early as possible. They also note that more research is required to establish whether it is feasible and cost-effective to treat patients with CBT over the long-term.

Cognitive Behavioral Therapy Improves Insomnia from Chronic Pain
Cognitive behavioral therapy improved insomnia, pain, and depression in patients with chronic pain.

The University of Warwick academics found that cognitive behavioral therapies (CBT) were either moderately or strongly effective in tackling insomnia in patients with long-term pain. They also discovered that chronic pain sufferers didn't just benefit from improved sleep but also experienced a wider positive impact on pain, fatigue and depression. However they also concluded that therapies only worked when delivered in person.

The study has been published in the journal Sleep. Dr. Nicole Tang, from the University's Department of Psychology who led the research said, "Poor sleep is a potential cause of ill health and previous studies suggest it can lead to obesity, diabetes, stroke, coronary heart disease and even death. Insomnia can also increase the risk of depression, anxiety and substance misuse. It is also a major problem for those suffering pain that lasts longer than three to six months and that is why we looked at this group.

"This study is particularly important because the use of drugs to treat insomnia is not recommended tover a long period of time. Therefore, the condition needs to be addressed using a non-pharmacological treatment. We believe that our results will be of particular interest to primary care physicians and allied health professionals who are taking up an increasingly important role in preventing and managing long-term conditions."

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