Michael V Vitiello1, Susan M McCurry2, Susan M Shortreed3, Benjamin H Balderson3, Laura D Baker1, Francis J Keefe4, Bruce D Rybarczyk5, Michael Von Korff3. 1. Department ofPsychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington. 2. Department ofPsychosocial and Community Health, School of Medicine, University of Washington, Seattle, Washington. 3. Group Health Research Institute, Seattle, Washington. 4. Department of Psychology, Duke University Medical Center, Durham, North Carolina. 5. Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
Abstract
OBJECTIVES: To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive-behavioral therapy for pain and insomnia (CBT-PI), a cognitive-behavioral pain coping skills intervention (CBT-P), and an education-only control (EOC) differed in sleep and pain outcomes. DESIGN: Double-blind, cluster-randomized controlled trial with 9-month follow-up. SETTING: Group Health and University of Washington, 2009 to 2011. PARTICIPANTS: Three hundred sixty-seven older adults with OA pain and insomnia. INTERVENTIONS: Six weekly group sessions of CBT-PI, CBT-P, or EOC delivered in participants' primary care clinics. MEASUREMENTS: Primary outcomes were insomnia severity and pain severity. Secondary outcomes were actigraphically measured sleep efficiency and arthritis symptoms. RESULTS: CBT-PI reduced insomnia severity (score range 0-28) more than EOC (adjusted mean difference = -1.89, 95% confidence interval = -2.83 to -0.96; P < .001) and CBT-P (adjusted mean difference = -2.03, 95% CI = -3.01 to -1.04; P < .001) and improved sleep efficiency (score range 0-100) more than EOC (adjusted mean difference = 2.64, 95% CI = 0.44-4.84; P = .02). CBT-P did not improve insomnia severity more than EOC, but improved sleep efficiency (adjusted mean difference = 2.91, 95% CI = 0.85-4.97; P = .006). Pain severity and arthritis symptoms did not differ between the three arms. A planned analysis in participants with severe baseline pain revealed similar results. CONCLUSION: Over 9 months, CBT of insomnia was effective for older adults with OA pain and insomnia. The addition of CBT for insomnia to CBT for pain alone improved outcomes.
OBJECTIVES: To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive-behavioral therapy for pain and insomnia (CBT-PI), a cognitive-behavioral pain coping skills intervention (CBT-P), and an education-only control (EOC) differed in sleep and pain outcomes. DESIGN: Double-blind, cluster-randomized controlled trial with 9-month follow-up. SETTING: Group Health and University of Washington, 2009 to 2011. PARTICIPANTS: Three hundred sixty-seven older adults with OA pain and insomnia. INTERVENTIONS: Six weekly group sessions of CBT-PI, CBT-P, or EOC delivered in participants' primary care clinics. MEASUREMENTS: Primary outcomes were insomnia severity and pain severity. Secondary outcomes were actigraphically measured sleep efficiency and arthritis symptoms. RESULTS: CBT-PI reduced insomnia severity (score range 0-28) more than EOC (adjusted mean difference = -1.89, 95% confidence interval = -2.83 to -0.96; P < .001) and CBT-P (adjusted mean difference = -2.03, 95% CI = -3.01 to -1.04; P < .001) and improved sleep efficiency (score range 0-100) more than EOC (adjusted mean difference = 2.64, 95% CI = 0.44-4.84; P = .02). CBT-P did not improve insomnia severity more than EOC, but improved sleep efficiency (adjusted mean difference = 2.91, 95% CI = 0.85-4.97; P = .006). Pain severity and arthritis symptoms did not differ between the three arms. A planned analysis in participants with severe baseline pain revealed similar results. CONCLUSION: Over 9 months, CBT of insomnia was effective for older adults with OA pain and insomnia. The addition of CBT for insomnia to CBT for pain alone improved outcomes.
Authors: Robert H Dworkin; Dennis C Turk; Kathleen W Wyrwich; Dorcas Beaton; Charles S Cleeland; John T Farrar; Jennifer A Haythornthwaite; Mark P Jensen; Robert D Kerns; Deborah N Ader; Nancy Brandenburg; Laurie B Burke; David Cella; Julie Chandler; Penny Cowan; Rozalina Dimitrova; Raymond Dionne; Sharon Hertz; Alejandro R Jadad; Nathaniel P Katz; Henrik Kehlet; Lynn D Kramer; Donald C Manning; Cynthia McCormick; Michael P McDermott; Henry J McQuay; Sanjay Patel; Linda Porter; Steve Quessy; Bob A Rappaport; Christine Rauschkolb; Dennis A Revicki; Margaret Rothman; Kenneth E Schmader; Brett R Stacey; Joseph W Stauffer; Thorsten von Stein; Richard E White; James Witter; Stojan Zavisic Journal: J Pain Date: 2007-12-11 Impact factor: 5.820
Authors: Susan M McCurry; Michael Von Korff; Charles M Morin; Amy Cunningham; Kenneth C Pike; Manu Thakral; Robert Wellman; Kai Yeung; Weiwei Zhu; Michael V Vitiello Journal: Contemp Clin Trials Date: 2019-10-13 Impact factor: 2.226
Authors: Nicole K Y Tang; S Tanya Lereya; Hayley Boulton; Michelle A Miller; Dieter Wolke; Francesco P Cappuccio Journal: Sleep Date: 2015-11-01 Impact factor: 5.849
Authors: Kelly M Shaffer; Fabian Camacho; Holly R Lord; Philip I Chow; Tonya Palermo; Emily Law; Frances P Thorndike; Karen S Ingersoll; Lee M Ritterband Journal: J Behav Med Date: 2019-05-31
Authors: Benjamin H Balderson; Susan M McCurry; Michael V Vitiello; Susan M Shortreed; Bruce D Rybarczyk; Francis J Keefe; Michael Von Korff Journal: Behav Sleep Med Date: 2015-10-20 Impact factor: 2.964
Authors: Scott G Williams; Jacob Collen; Emerson Wickwire; Christopher J Lettieri; Vincent Mysliwiec Journal: Curr Psychiatry Rep Date: 2014-08 Impact factor: 5.285
Authors: Kathi L Heffner; Christopher R France; Lisham Ashrafioun; Maria Quiñones; Patrick Walsh; Michael D Maloney; Brian D Giordano; Wilfred R Pigeon Journal: Clin J Pain Date: 2018-12 Impact factor: 3.442
Authors: Michael T Smith; Patrick H Finan; Luis F Buenaver; Mercedes Robinson; Uzma Haque; Angela Quain; Erin McInrue; Dingfen Han; Jeannie Leoutsakis; Jennifer A Haythornthwaite Journal: Arthritis Rheumatol Date: 2015-05 Impact factor: 10.995
Authors: Juyoung Park; David Newman; Ruth McCaffrey; Jacinto J Garrido; Mary Lou Riccio; Patricia Liehr Journal: J Gerontol Soc Work Date: 2016 Oct - Nov