A brief cognitive–behavioral intervention for sleep in individuals with chronic noncancer pain: A randomized controlled trial.

Berry, Robyn; Verrier, Michelle J.; Rashiq, Saifee; Simmonds, Mark; Baloukov, Alexander; Thottungal, James; McWilliams, Lachlan A.; Olechowski, Camille; Dick, Bruce

doi:10.1037/rep0000035

Cited by 5 publications

(6 citation statements)

References 36 publications

(39 reference statements)

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“… 1b. Brief cognitive behavioural therapy and sleep hygiene compared with wait list controls Berry et al 2015 [ 49 ] Canada, dates not stated Outpatient clinic Parallel group RCT Chronic non-cancer pain including neuropathic pain, musculoskeletal pain, complex regional pain syndrome, joint pain, visceral pain and headaches, age 18–80 years 132 (65;67) Mean 49 years 61% female Education with CBT component. Education session incorporating sleep hygiene and cognitive behavioral strategies 15 min session once.…”

Section: Resultsmentioning

confidence: 99%

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The effectiveness of non-pharmacological sleep interventions for people with chronic pain: a systematic review and meta-analysis

Whale

Dennis

Wylde

et al. 2022

BMC Musculoskelet Disord

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Objective About two thirds of people with chronic pain report problems sleeping. We aimed to evaluate the effectiveness of non-pharmacological sleep interventions for improving sleep in people with chronic pain. Design We conducted a systematic review of non-pharmacological and non-invasive interventions to improve sleep quality or duration for adults with chronic non-cancer pain evaluated in a randomised controlled trial. Our primary outcome of interest was sleep; secondary outcomes included pain, health-related quality of life, and psychological wellbeing. We searched the Cochrane Library, MEDLINE, Embase, PsycINFO and CINAHL from inception to April 2020. After screening, two reviewers evaluated articles and extracted data. Meta-analysis was conducted using a random effects model. Risk of bias was assessed with the Cochrane tool. Results We included 42 trials involving 3346 people randomised to 94 groups, of which 56 received an intervention targeting sleep. 10 studies were of fair and 32 of good methodological quality. Overall risk of bias was judged to be low in 11, high in 10 and unclear in 21 studies. In 9 studies with 385 people randomised, cognitive behavioural therapy for insomnia showed benefit post-treatment compared with controls for improved sleep quality, standardised mean difference − 1.23 (95%CI -1.76, − 0.70; p < 0.00001). The effect size was only slightly reduced in meta-analysis of 3 studies at low risk of bias. The difference between groups was lower at 3 and 6 months after treatment but still favoured cognitive behavioural therapy for insomnia. Pain, anxiety and depression were reduced post-treatment, but evidence of longer term benefit was lacking. There was no evidence that sleep hygiene interventions were effective in improving sleep and there was some evidence in comparative studies to suggest that cognitive behavioural therapy for insomnia was more effective than sleep hygiene. Numerous other interventions were evaluated in small numbers of studies, but evidence was insufficient to draw conclusions about effectiveness. Conclusions Cognitive behavioural therapy for insomnia is an effective treatment to improve sleep for people with chronic pain, but further high-quality primary research is required to explore combined CBT content that will ensure additional improvements to pain, quality of life and psychological health and longer-term maintenance of benefits. Primary research is also needed to evaluate the effectiveness of interventions for which insufficient evidence exists. Trial registration PROSPERO registration number: CRD42019093799.

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Section: Resultsmentioning

confidence: 99%

“…In 1 study with 132 people with chronic non-cancer pain randomised, a brief educational intervention incorporating sleep hygiene and cognitive behavioural strategies was compared with wait list controls [ 49 ]. The study was at high risk of bias due to large losses to follow up.…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of non-pharmacological sleep interventions for people with chronic pain: a systematic review and meta-analysis

Whale

Dennis

Wylde

et al. 2022

BMC Musculoskelet Disord

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“…One study was identified that investigated the influence of education about healthy sleep as a sleep hygiene strategy. 74 Berry et al 74 conducted a randomised controlled trial with 85 participants with chronic non-cancer pain and…”

Section: Educationmentioning

confidence: 99%

Sleep hygiene strategies for individuals with chronic pain: a scoping review

Gupta

Sprajcer²,

Johnston-Devin³

et al. 2023

BMJ Open

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ObjectivesUp to a quarter of the world’s population experience chronic pain, which, in addition to interfering with daily activities and waking function, is often associated with poor sleep. Individuals experiencing poor sleep are often encouraged to implement sleep hygiene strategies. However, current sleep hygiene strategies have not been developed considering the unique challenges faced by individuals with chronic pain and therefore they might not be as effective in this population. The aim of this scoping review is to map the state of the existing literature examining sleep hygiene strategies in individuals with chronic pain.DesignThis scoping review included a search of four online databases (Medline, Embase, PsycINFO and CINAHL) to identify articles examining the use of sleep hygiene strategies in populations with chronic pain.ResultsThirty articles investigated at least one sleep hygiene strategy in individuals with chronic pain, with improvements to sleep reported for six sleep hygiene strategies (education, exercise, limiting alcohol use, limiting tobacco use, prebed state and sleep environment). However, the timing of these strategies was often not reported which limits the degree to which these strategies can be generalised for use as a presleep strategy.ConclusionThis scoping review examined the existing literature focusing on sleep hygiene strategies for people with chronic pain. There are limitations to the methodology of the existing literature and gaps in our understanding of sleep hygiene strategies in some chronic pain conditions that must be addressed in future research before the effectiveness of these strategies can be understood.

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“…Darüber hinaus sind sowohl Ein-und Durchschlafstörungen als auch chronische Schmerzen mit Anspannung und Ängsten sowie Hilflosigkeit und Depressivität verbunden [10][11][12][13][14][15]. Somit liegt die Notwendigkeit einer gemeinsamen Behandlung von chronischen Schmerzen und insomnischen Beschwerden nahe [1,2,16]. Genau hier setzt unser Trainingsprogramm an: Es basiert auf bewährten Methoden der kognitiven Verhaltenstherapie bei Insomnie und wurde um Methoden der psychologischen Schmerztherapie erweitert (z.…”

Section: Zusammenfassungunclassified

“…B. [16][17][18]. Konzepte, die eine umfassende verhaltenstherapeutische Behandlung von Schlaf und Schmerz beinhalten, finden sich jedoch kaum [vgl.…”

Section: Besonderheiten Des Vorliegenden Schlaftrainings Bei Chronisc...unclassified

Besserer Schlaf und weniger Schmerzen? Schlaftraining in der orthopädischen Rehabilitation

Tscharaktschiew

Ende

Onderka

2021

Rehabilitation (Stuttg)

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Zusammenfassung Ziel der Studie Es besteht eine hohe Komorbidität zwischen chronischen Schmerzen und Ein- und Durchschlafstörungen (Insomnien). Hierbei wirken sich die Schmerzen nicht nur störend auf den Schlaf aus – eine schlechte Schlafqualität kann auch das Schmerzempfinden verstärken. Bisher erfolgt die Behandlung beider Störungsbilder jedoch größtenteils separat. In einer Pilotstudie wurde die Wirkung eines kognitiv-verhaltenstherapeutischen Schlaftrainings, das auf die gemeinsame Behandlung beider Störungsbilder abzielt, im Bereich der ambulanten orthopädischen Rehabilitation untersucht. Methodik N=41 Patient/innen nahmen an der Untersuchung teil, wobei 15 Teilnehmer/innen der Kontrollgruppe angehörten. Das Training umfasst 4 Module á 90min und wurde speziell für Patient/innen mit chronischen Schmerzen und komorbider Insomnie konzipiert. Es beinhaltet verschiedene Maßnahmen der kognitiven Verhaltenstherapie zur Behandlung von Insomnie und chronischen Schmerzen (z. B. Schlafhygiene, Schlafrestriktion, Schlaf-Schmerz-Protokoll, kognitive Umstrukturierung) und adressiert speziell den Zusammenhang zwischen Schlaf und Schmerz. Vor und nach dem Training wurden Schlafqualität, schlafbezogene Gedanken (Focussing, Grübeln), internale gesundheitsbezogene Kontrollüberzeugung, Schmerzstärke (am Tag und in der Nacht) sowie schmerzbezogene Gedanken (schmerzbezogene Ängste, schmerzbezogene Hilflosigkeit/Depression) mittels Fragebogen erfasst. Ergebnisse Für die meisten Parameter (Schlafqualität, Schlafeffizienz, Focussing, Grübeln, internale gesundheitliche Kontrollüberzeugung, durchschnittliche Schmerzen am Tag und in der Nacht, maximale Schmerzen in der Nacht, schmerzbezogene Ängste und schmerzbezogene Hilflosigkeit/Depression) ergaben gemischte Varianzanalysen (kleine η²=0,010 bis mittlere η²=0,068) Interaktionseffekte zwischen Messzeitpunkt und Gruppe, wobei die Effekte für Grübeln und durchschnittliche Schmerzen am Tag nicht signifikant waren. Für die maximalen Schmerzen am Tag zeigte sich kein Interaktionseffekt. Effektgrößen für den Prä-Post-Vergleich der einzelnen Gruppen ergaben mittlere (internale gesundheitsbezogene Kontrollüberzeugung: d=0,52) bis große (Schlafqualität: d=1,73) signifikante Verbesserungen für die Trainingsgruppe. Für die Kontrollgruppe zeigten sich keine (Focussing: d=0,00) bis kleine (maximale Schmerzstärke am Tag: d=−0,43) jedoch stets nicht signifikante Effekte. Schlussfolgerung Das vorliegende Trainingsprogramm könnte eine Ergänzung zum herkömmlichen Behandlungsspektrum bei chronischen Schmerzen darstellen und sollte an größeren Stichproben weiter evaluiert werden.

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A brief cognitive–behavioral intervention for sleep in individuals with chronic noncancer pain: A randomized controlled trial.

Abstract: Our findings suggest that there is potential for a brief educational intervention to have a positive impact on some aspects of sleep in the chronic pain population.

Cited by 5 publications

References 36 publications

The effectiveness of non-pharmacological sleep interventions for people with chronic pain: a systematic review and meta-analysis

The effectiveness of non-pharmacological sleep interventions for people with chronic pain: a systematic review and meta-analysis

Sleep hygiene strategies for individuals with chronic pain: a scoping review

Besserer Schlaf und weniger Schmerzen? Schlaftraining in der orthopädischen Rehabilitation

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