The key components of this intervention are sleep restriction therapy, which limits time in bed initially to the duration of actual sleep per night, and stimulus control, which involves modification of factors that associate bed/nighttime with wakefulness (e.g., time awake in bed, wakeful activities in bed Williams et al., 2013). Accordingly, CBT-I uses conditioning principles to decrease pre-sleep arousal and recondition a pattern of rapid, consolidated sleep. In this treatment model, insomnia is viewed as originating from varying precipitating events (e.g., illness, life changes, pain symptoms), but maintained through sleep-related behaviors that increase sleep-related arousal, fragment sleep, and condition an association between bed/nighttime and wakefulness. Accordingly, there is a significant need for dual treatment models that address both chronic pain and insomnia.Ĭognitive-behavioral therapy for insomnia (CBT-I) is an evidence-based intervention for insomnia. Importantly, for patients with clinically significant insomnia symptoms, insomnia often does not improve to a meaningful extent as a result of chronic pain treatment alone (e.g., Pigeon et al., 2012). More specifically, studies have found that higher levels of insomnia are associated with increased difficulty in reducing opioid use, higher pain intensity, greater functional limitations, lower self-efficacy, higher pain catastrophizing, and more depressive symptoms compared to patients with less severe insomnia ( Asih et al., 2014 Pigeon et al., 2012). Patients with comorbid insomnia and chronic pain are at higher risk of negative outcomes compared to individuals without insomnia ( Tang, 2009). Estimates suggest that most patients seeking treatment for chronic pain also report moderate to severe clinical insomnia symptoms ( Tang, 2008). Se necesitan mayores esfuerzos para trabajar con problemas del sueño en el entorno de los programas de rehabilitación del dolor.Ĭooccurring insomnia complicates the severity of and treatment outcomes for chronic pain. Menos de un tercio de los participantes informaron reducciones clínicamente significativas en síntomas de insomnio después de participar en IPRP. Ambos grupos informaron reducciones en insomnio, gravedad del dolor, nivel de interferencia en la vida relacionada con el dolor y estado de ánimo deprimido. Los pacientes IPRP + CBT-I mostraron mejoría en síntomas de insomnio al final del estudio en comparación con el comienzo del grupo CBT-I no hubo diferencias significativas en los resultados de IPRP en relación con la condición de IPRP-UC. Se examinaron los resultados relacionados con insomnio y dolor en adultos que participaban en un IPRP de diez semanas ( N = 79) asignados a CBT grupal de cuatro sesiones (IPRP + CBT-I) o nivel de cuidado habitual (IPRP-UC). Se investiga la translación de la CBT-I en un IPRP. La terapia cognitivo-conductual para el insomnio (CBT-I, por siglas en inglés) es una intervención basada en la evidencia. Investigaciones indican que el nivel de cuidado habitual (UC, por siglas en inglés) de los programas interdisciplinarios de rehabilitación del dolor (IPRP, por siglas en inglés) no abordan suficientemente los problemas del sueño entre personas que padecen dolor crónico comórbido con niveles clínicos de insomnio. Conclusionsįurther efforts are needed to address sleep problems in pain rehabilitation settings. Fewer than one-third of participants reported clinically meaningful reductions in insomnia symptoms following IPRP participation. Both groups reported statistically significant reductions in insomnia, pain severity, pain-related life interference, and depressed mood. Patients in the IPRP+CBT-I group showed improvements in insomnia symptoms at the end compared to the beginning of the CBT-I group however, there were no IPRP outcome differences relative to the IPRP-UC condition. In this single-site, prospective, randomized controlled pilot study, insomnia and pain-related outcomes were examined for adults participating in a 10-week IPRP ( N = 79) who were allocated to a 4-session group-based CBT-I (IPRP+CBT-I) or usual care (IPRP-UC) condition. The current study investigates the translation of CBT-I into an IPRP. Cognitive behavioral therapy for insomnia (CBT-I) is an evidence-based insomnia intervention. Prior research indicates interdisciplinary pain rehabilitation program (IPRP) usual care (UC) does not sufficiently address sleep problems among individuals with comorbid chronic pain and clinical levels of insomnia.
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