Internet-Delivered Cognitive Behavioral Therapy for Insomnia Comorbid With Chronic Pain: Randomized Controlled Trial

Area of Science:

• Behavioral Science
• Clinical Psychology
• Sleep Medicine

Background:

• Chronic pain and insomnia frequently coexist, creating a significant patient burden.
• The bidirectional relationship between pain and insomnia necessitates effective interventions.
• Evaluating insomnia treatments for chronic pain patients is crucial.

Purpose of the Study:

• To assess the effectiveness of internet-based cognitive behavioral therapy for insomnia (ICBT-i) in reducing insomnia severity and improving sleep and pain parameters in chronic pain patients.
• To compare ICBT-i with an active control (applied relaxation) delivered via the internet.
• To evaluate anxiety, depression, and pain-related outcomes.

Main Methods:

• A randomized controlled trial involving 54 patients in the ICBT-i group and 24 in the applied relaxation group.
• Internet-delivered interventions over a 5-week period.
• Assessment of Insomnia Severity Index (ISI), sleep diary, anxiety, depression, and pain parameters at baseline, post-treatment, and 6-month follow-up.

Main Results:

• ICBT-i demonstrated a significant immediate improvement in insomnia severity (ISI) and sleep parameters compared to applied relaxation.
• Both groups showed improvements in anxiety and depression at 6-month follow-up, but not in pain-related parameters.
• No significant differences in sleep parameters were observed between ICBT-i and applied relaxation at the 6-month follow-up.

Conclusions:

• Brief ICBT-i offers a faster reduction in insomnia symptoms for chronic pain patients compared to applied relaxation.
• Larger sample studies are needed to confirm these unique findings.
• Combining ICBT-i with applied relaxation may enhance outcomes for patients with comorbid insomnia and chronic pain.