Navigation Links
Cognitive behavioral therapy improves sleep and pain in people with osteoarthritis
Date:8/15/2009

Westchester, Ill. A study in the Aug. 15 issue of the Journal of Clinical Sleep Medicine shows that the use of cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for older patients with osteoarthritis and comorbid insomnia.

Results showed that treatment improves both immediate and long-term self-reported sleep and pain in older patients with osteoarthritis and comorbid insomnia without directly addressing pain control. Participants who received CBT-I reported significantly decreased sleep latency (initially decreased by an average of 16.9 minutes and 11 minutes a year after treatment) and wake after sleep onset (initially decreased by an average of 37 minutes and 19.9 minutes a year after treatment), significantly reduced pain (initially improved by 9.7 points and 4.7 points a year after treatment) and increased sleep efficiency (initially increased by 13 percent and 8 percent a year after treatment). These improvements persisted in CBT-I patients (19 of 23) who were further assessed for sleep quality and perceived pain at a one-year follow-up visit.

According to lead author Michael V. Vitiello, PhD, professor at the University of Washington in Seattle, Wash., results indicate that insomnia is not merely a symptom of osteoarthritis but rather a co-existing illness. Vitiello said improving sleep can result in an improvement in osteoarthritis, which is particularly important because, at least in older adults, insomnia rarely exits by itself, rather it typically coexists with other illnesses, pain conditions and depression.

"The particular strength of CBT-I 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," said

{ 1 of 3}

Vitiello. "What we and others are showing is that CBT-I can not only improve sleep but that improvement of sleep may lead to improvement in co-existing medical or psychiatric illnesses, such as osteoarthritis or depression, and in the case of our study, that these additional benefits can be seen in the long term."

A total of 23 patients with a mean age of 69 years were randomly assigned to CBT-I, while 28 patients with a mean age of 66.5 years were assigned to a stress management and wellness control group. Participants in the control group reported no significant improvements in any measure.

CBT-I intervention consisted of eight weekly, two-hour classes ranging in size from four to eight participants. All classes were conducted in an academic medical center in downtown Chicago and were spread out over the calendar year. Participants received polysomnographic assessment in their home in order to exclude individuals with sleep apnea. Sleep and pain were assessed by self-report at baseline, after treatment, and (for CBT-I only) at one year follow-up. Sleep logs were recorded prior to and after treatment and at the one year follow-up and included information about sleep latency, wake after sleep onset and sleep efficiency. Subjects were required to be over the age of 55, have insomnia symptoms that have persisted for at least six months and have been diagnosed with osteoarthritis. A majority of the sample was female. Volunteers were recruited from placements of brochures, memos and flyers in places where medical patients who qualified for the study might see them.

According to the study, sleep quality is a major concern for people with osteoarthritis, with 60 percent of people who have the disease reporting pain during the night. Chronic pain initiates and exacerbates sleep disturbance; disturbed sleep in turn maintains and exacerbates chronic pain and related dysfunction.

The findings indicate that successful treatment of sleep disturbance may improve the quality of life for patients in this population. The authors recommend that CBT-I, which specifically targets sleep, be incorporated into behavioral interventions for pain management in osteoarthritis and possibly for other chronic pain conditions as well.


'/>"/>

Contact: Kelly Wagner
kwagner@aasmnet.org
708-492-0930
American Academy of Sleep Medicine
Source:Eurekalert

Related medicine news :

1. Lack of sleep among new school-goers leads to behavioral, cognitive problems
2. Low level of neuronal receptor linked to mild cognitive impairment and Alzheimers disease
3. Cognitive Activities Protect Against Alzheimers -- Social and Physical Activities Not Enough
4. Potential new approach to treat cognitive impairments in schizophrenia
5. Cognitive deficits lead to loss of self among cancer patients
6. Research links diet to cognitive decline and dementia
7. First Cognitive Training to Demonstrate Immediate Generalizability Through Standardized Assessments of Memory
8. New research on aging and cognitive training presented at GSAs Annual Meeting
9. Hypertension Linked to Risk of Mild Cognitive Impairment
10. Rhode Island Hospital to study driving ability of cognitively impaired elders
11. Older surgical patients at greater risk for developing cognitive problems
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library on June 21 due ... up a new, often overlooked aspect of head lice: the parasite’s ability to live away ... a common occurrence, but a necessary one in the event that lice have simply gotten ...
(Date:6/25/2016)... ... June 25, 2016 , ... Dr. Calvin Johnson ... Recently, he has implemented orthobiologic procedures as a method for treating his patients. ... the first doctors to perform the treatment. Orthobiologics are substances that orthopaedic surgeons ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events may ... to unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. To ... for healthy coping following a traumatic event. , Trauma sufferers tend to feel a ...
(Date:6/24/2016)... ... ... Global law firm Greenberg Traurig, P.A. announced that 20 Florida attorneys are ... for this recognition are considered among the top 2 percent of lawyers practicing within ... of this year’s Legal Elite Hall of Fame: Miami Shareholders Mark D. Bloom, ...
(Date:6/24/2016)... ... 2016 , ... People across the U.S. are sharpening their pencils and honing ... contest in which patients and their families pay tribute to a genetic counselor by ... Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. , In ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Revolutionary technology includes multi-speaker listening to ... leaders in advanced audiology and hearing aid technology, has ... the world,s first internet connected hearing aid that opens ...      (Photo: http://photos.prnewswire.com/prnh/20160622/382240 ) , ... firsts,: , TwinLink™ - the first dual ...
(Date:6/23/2016)... , June 23, 2016 The vast majority ... outpatient dialysis facility.  Treatments are usually 3 times a ... per visit, including travel time, equipment preparation and wait ... but especially grueling for patients who are elderly and ... skilled nursing and rehabilitation centers for some duration of ...
(Date:6/23/2016)... FRANKLIN, Tenn. , June 23, 2016 ... for automating, integrating and transforming the patient ... launch of several innovative new products and ... depth of its revenue cycle offerings. These ... establish more efficient workflows, remain compliant in ...
Breaking Medicine Technology: