The treatment of veterans with chronic pain and insomnia with cognitive behavioral therapy for insomnia (CBT-I) may improve sleep and mood, but not pain, according to study results published in Pain Medicine.

In this study, 17 veterans with chronic pain and insomnia who had recently participated in CBT-I and 7 of their CBT-I therapists were enrolled. Therapy sessions were based on a CBT-I model developed by Veterans Affairs. Conceptual themes were identified using qualitative semistructured interviews and thematic analysis.

Musculoskeletal pain (eg, back and joint pain) was the pain condition most commonly reported by participants. Participants completed an average of 5 CBT-I sessions (range, 2-10 sessions). Both participants and therapists noted that changing sleep habits during CBT-I could be challenging. Challenges reported included anxiety associated with having to change one’s schedule and difficulty staying awake until the scheduled bedtime. Neither the participants nor therapists reported any major pain-related barriers that prevented them from adhering to CBT-I recommendations.

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Although participants had only minimal changes in pain intensity, they reported improvements in sleep, energy, mood, and socialization after CBT-I.

The results of the surveys indicated that participants valued their experience with CBT-I and would recommend this treatment to other patients with comorbid insomnia and pain. Several participants recommended CBT-I to friends, family, and colleagues.

“Continuing efforts are needed to enhance CBT-I adherence for all patients with insomnia, with a focus on challenging treatment components like sleep restriction,” noted the researchers.

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Reference

Koffel E, Amundson E, Wisdom JP. Exploring the meaning of cognitive behavioral therapy for insomnia for patients with chronic pain [published online July 4, 2019]. Pain Med. doi:10.1093/pm/pnz144