Behavioral Therapy for Pain and Insomnia

Aug. 15, 2009 -- Cognitive behavioral therapy for insomnia may help older people who suffer pain from osteoarthritis, a new study shows.

The researchers conclude that cognitive behavioral therapy to help with sleep should be considered to help manage chronic pain conditions such as osteoarthritis.

"The particular strength of [cognitive behavioral therapy aimed at insomnia] is that once an individual learns how to improve their sleep, study after study has shown that the improvement persists for a year or more," Michael V. Vitiello, PhD, of the University of Washington in Seattle, says in a news release.

Better sleep can lead to improvement in coexisting medical or psychiatric illnesses, Vitiello says.
His research team assigned 23 older patients with osteoarthritis to cognitive behavioral therapy that was aimed at helping them learn how to sleep better. Twenty-eight other patients were assigned to a stress management and wellness program.

Those receiving the cognitive behavioral therapy reported improvements in sleep quality and pain relief measures before and after treatment, and a year later. Participants in the group that didn't get the cognitive behavioral therapy showed no significant improvements in sleep quality or pain.

"Sleep quality is a major concern of people with osteoarthritis, with 60 percent of people with the disease reporting pain during the night. ... Whether sleep disturbance preceded or follows pain onset is unclear, but reciprocal effects are likely," write the researchers.

Chronic pain initiates and exacerbates sleep disturbances, but the researchers say pain perception may decrease when people sleep better.