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Nov 13

CBT Can Ease Insomnia for Those with Chronic Pain


By Janice Wood

A new study indicates that chronic pain sufferers could benefit from therapy to help them sleep better.

Researchers at the University of Warwick in the U.K. 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, the study also concluded that CBT only worked when delivered in person.

“Poor sleep is a potential cause of ill health and previous studies suggest it can lead to obesity, diabetes, stroke, coronary heart disease — even death,” said Dr. Nicole Tang, from the university’s Department of Psychology, who led the research.

“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.”

She noted the study is “particularly important because the use of drugs to treat insomnia is not recommended over a long period of time,” which means the “condition needs to be addressed using a non-pharmacological treatment.”

Researchers from the university’s Department of Psychology and Warwick Medical School ran a meta-analysis of the effects of non-drug treatments for sleeplessness, examining 72 studies that included 1,066 patients between the ages 45 and 61 who suffered from insomnia and experienced pain caused by a variety of ailments, such as cancer, headaches, and arthritis.

Treatments covered a variety of approaches, including education about sleep hygiene (good sleeping habits, such as a regular sleeping pattern), stimulus control, sleep restriction and cognitive therapy.

In addition to highlighting the positive effect of CBT on insomnia, the researchers identified a mild to moderate decrease in pain immediately after therapy.

The researchers also noted that improved sleep resulted in a decrease in depression following treatment and at follow-ups up to 12 months. The researchers said this highlights the value of treating insomnia that exists with chronic pain as early as possible.

The therapies were found to be less effective when delivered over the phone or Internet, Tang reported.

“We found little evidence that using therapies delivered either by phone or computer benefited insomniacs,” she said. “The jury is still out on the effectiveness of using automated sleep treatments. We found that, at the moment at least, delivering therapies personally had the most positive effect on sleeplessness.”

The scientists concluded that more research is required to establish if it is feasible and cost-effective over the long-term to treat patients using CBT.

The study was published in the journal Sleep.

Source: University of Warwick

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