Psychological interventions that target sleep reduce pain catastrophizing in knee osteoarthritis

Abstract

Pain catastrophizing is a significant risk factor for patients with knee osteoarthritis (KOA) and thus is a target for many psychological interventions for pain. This study examined if interventions targeting sleep found to be effective in improving sleep in KOA also reduce pain catastrophizing measured as a trait through the pain catastrophizing scale and measured as a daytime and nocturnal state through daily diaries. Secondary analyses were conducted on data collected as part of a randomized controlled trial assessing the effectiveness of cognitive behavioral therapy for insomnia in patients with KOA at 5 different time points: pretreatment, midtreatment and posttreatment and at 3- and 6-month follow-up. One hundred patients diagnosed with KOA and insomnia were randomized to receive either 8 sessions of cognitive behavioral therapy for insomnia or a placebo intervention of behavioral desensitization. Multilevel modeling revealed that both intervention groups showed a significant reduction pretreatment to posttreatment in all 3 measures of pain catastrophizing and maintained stable levels through the 6-month follow-up. Increased sleep continuity early in treatment (pretreatment to midtreatment), but not reductions in pain, was associated with a reduction in trait and nocturnal catastrophizing later in treatment (midtreatment to posttreatment). These results suggest that short interventions focusing on sleep can significantly reduce pain catastrophizing even in a clinical population with low baseline levels of catastrophizing, possibly through improving sleep continuity.

Perioperative Pharmacological Sleep‐Promotion and Pain Control: A Systematic Review

“…In addition to pharmacological sleep modulation, it is imperative to investigate nonpharmacological perioperative sleep‐modulating measures. For example, cognitive behavioral therapy for insomnia (CBT‐I) is effective for relieving sleep problems, and for relieving comorbid insomnia associated with chronic pain . In an intensive care unit setting, nonpharmacological sleep‐promoting measures such as earplugs and eye masks may improve sleep and decrease the incidence of delirium .…”

Effects of Low-Intensity Pulsed Ultrasound on Knee Osteoarthritis: A Meta-Analysis of Randomized Clinical Trials

“…Pain management was a great concern for doctors in treating knee OA [ 19 , 20 ]. VAS scale was most reported to evaluate pain intensity (4 trials, n = 261) in the selected studies.…”

Reallocating time spent in sleep, sedentary behavior and physical activity and its association with pain: a pilot sleep study from the Osteoarthritis Initiative

“…However, data from previous studies suggest that sleep problems may modify the relationship between PA and pain through their effect on psychosocial factors and pain processing. Several studies have suggested that sleep problems are associated with psychosocial problems (e.g., catastrophizing, anxiety) and abnormalities in the central nervous system (CNS) pain processing 42,43 . People who report restless sleep may be more likely to have psychosocial problems and abnormalities in CNS pain processing.…”