Cognitive behavioral therapy for insomnia significantly improved sleep for patients with chronic neck or back pain and also reduced the extent to which pain interfered with their daily functioning, according to a study by University of Rochester Medical Center researchers.
The study, published online by the journal Sleep Medicine, demonstrates that a behavioral intervention can help patients who already are taking medications for pain and might be reluctant or unable to take additional drugs to treat sleep disturbance.
"This therapy made a major difference to these patients," said Carla R. Jungquist, F.N.P., Ph.D., of the Medical Center's Sleep and Neurophysiology Research Laboratory, who is the lead author of the Sleep Medicine article. "We saw very good treatment effects."
For the study, a nurse therapist delivered the eight weeks of cognitive behavioral therapy, which included sleep restriction, stimulus control, sleep hygiene, and one session devoted to discussion of catastrophic thoughts about the consequences of insomnia.
"This study really shows that this therapy can be delivered successfully and very effectively by advance practice nurses," Jungquist said. "Training nurses in the delivery of this type of therapy will result in better access for patients. Currently, access to this therapy is limited as there are few trained therapists and most are psychologists."
Patients with chronic pain often use sleep as an escape. They seek sleep when not sleepy, sleep in places other than the bedroom, and engage in non-sleep behaviors, such as watching television and resting a painful back, in the bedroom, the researchers report.
Using behavioral therapy instead of adding to their list of medications is a healthier and safer method of treating sleep disturbance, Jungquist said.
"We establish a structure for the times or hours spent in bed," Jungquist explained. "We focus on a patient's negative t
|Contact: Michael Wentzel|
University of Rochester Medical Center