The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Cognitive–Behavioral Therapy for Insomnia in Knee Osteoarthritis: A Randomized, Double‐Blind, Active Placebo–Controlled Clinical Trial
Open accessAbstract
Objective: Insomnia is prevalent among patients with knee osteoarthritis (OA). Research indicates that sleep disruption may amplify clinical pain by altering central pain modulation, suggesting that treatment of insomnia may improve pain. The aims of this study were to evaluate the efficacy of cognitive–behavioral therapy for insomnia (CBT‐I) in patients with knee OA, to determine whether improvements in sleep predict reduced pain, and to determine whether alterations in pain modulation mediate improvements in clinical pain. Methods: We conducted a randomized, double‐blind, active placebo–controlled clinical trial of CBT‐I in 100 patients with knee OA and insomnia (mean ± SD age 59.4 ± 9.5 years). Patients were randomized (1:1) to receive either 8 sessions of CBT‐I or behavioral desensitization (placebo). We conducted in‐home polysomnography (PSG), diary assessment, and sensory tests of pain modulation at baseline, posttreatment, 3 months, and 6 months. Results: Intent‐to‐treat analyses demonstrated substantial improvement in sleep in both groups of patients. Patients in the CBT‐I group had significantly greater reductions in wake after sleep onset (WASO), as measured by patient diary and PSG. Patients in both groups reported significant and comparable reductions in pain over 6 months, with one‐third reporting a 30% reduction in pain severity. Baseline‐to‐posttreatment reductions in WASO as measured by diary and PSG predicted subsequent decreases in clinical pain. This effect was significantly greater for CBT‐I compared with behavioral desensitization. No significant changes in laboratory measures of pain modulation were observed. Conclusion: Compared with active placebo, CBT‐I was efficacious in reducing sleep maintenance insomnia. CBT‐I decreased clinical pain, but not pain modulation, suggesting that it has the potential to augment pain management in knee OA. Future work is needed to identify the mechanisms by which improved sleep reduces clinical pain.
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Cites
Kok, J. S., Berg, I. J., & Scherder, E. J. A. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000353441 · Cited by 20,589
Validation of the Insomnia Severity Index as an outcome measure for insomnia research
Bastien, C. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00065-4 · Cited by 8,067
Dworkin, R. H., Turk, D. C., Wyrwich, K. W., Beaton, D., Cleeland, C. S., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Kerns, R. D., Ader, D. N., et al. (2008) · The Journal of Pain · doi:10.1016/j.jpain.2007.09.005 · Cited by 3,471
Self-citationThe American Geriatrics Society 2012 Beers Criteria Update Expert Panel (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.03923.x · Cited by 2,578
Credibility of analogue therapy rationales
Borkovec, T. D., & Nau, S. D. (1972) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(72)90045-6 · Cited by 1,553 · cited 1×
“At the end of the first and last treatment sessions, we administered the Therapy Evaluation Questionnaire (TEQ), a widely used, 8-item measure of perceived credibility, outcome expectancy, and therapist competence (45).”
MethodEdinger, J. D., Bonnet, M. H., Bootzin, R. R., Doghramji, K., Dorsey, C. M., Espie, C. A., Jamieson, A. O., McCall, W. V., Morin, C. M., & Stepanski, E. J. (2004) · Sleep · doi:10.1093/sleep/27.8.1567 · Cited by 1,039
Comparative Meta-Analysis of Pharmacotherapy and Behavior Therapy for Persistent Insomnia
Smith, M. T., Perlis, M. L., Park, A., Smith, M. S., Pennington, J., Giles, D. E., & Buysse, D. J. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.1.5 · Cited by 863 · cited 2×
“insomnia (14), is a promising approach to evaluating whether improving sleep maintenance improves OA”
BackgroundResultSelf-citationIncreasing the reliability and validity of pain intensity measurement in chronic pain patients
Jensen, M. P., & McFarland, C. A. (1993) · Pain · doi:10.1016/0304-3959(93)90148-i · Cited by 720
Edinger, J. D., Wohlgemuth, W. K., Radtke, R. A., Marsh, G. R., & Quillian, R. E. (2001) · JAMA · doi:10.1001/jama.285.14.1856 · Cited by 625 · cited 2×
“Behavioral desensitization has been used successfully as a credible placebo in a clinical trial in primary insomnia (44).”
MethodResultThe effects of sleep deprivation on pain inhibition and spontaneous pain in women
Smith, M. T., Edwards, R. R., McCann, U. D., & Haythornthwaite, J. A. (2007) · Sleep · doi:10.1093/sleep/30.4.494 · Cited by 539
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Cited by
Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis
van Straten, A., van der Zweerde, T., Kleiboer, A., Cuijpers, P., Morin, C. M., & Lancee, J. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2017.02.001 · Cited by 676
Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications
Haack, M., Simpson, N., Sethna, N., Kaur, S., & Mullington, J. (2020) · Neuropsychopharmacology · doi:10.1038/s41386-019-0439-z · Cited by 641
van der Zweerde, T., Bisdounis, L., Kyle, S. D., Lancee, J., & van Straten, A. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.08.002 · Cited by 336
Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., et al. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8988 · Cited by 309
Selvanathan, J., Pham, C., Nagappa, M., Peng, P. W. H., Englesakis, M., Espie, C. A., Morin, C. M., & Chung, F. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101460 · Cited by 206
Metadata
- Authors
- Smith, M. T., Finan, P. H., Buenaver, L. F., Robinson, M., Haque, U., Quain, A., McInrue, E., Han, D., Leoutsakis, J., & Haythornthwaite, J. A.
- Venue
- Arthritis & Rheumatology
- Publisher
- Wiley
- Published
- 2015-04-27
- Volume
- 67
- Issue
- 5
- Pages
- 1221-1233
- ISSN
- 2326-5191 (ISSN-L)
- 2326-5205
- OpenAlex
- W2119685876
- Cited by
- 159
- References
- 23
- FWCI
- 21.68
- Type
- journal article
- Language
- en
- Open access
- green
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- CoChat. (2026). Citation check: Cognitive–Behavioral Therapy for Insomnia in Knee Osteoarthritis: A Randomized, Double‐Blind, Active Placebo–Controlled Clinical Trial. https://app.cochat.ai/papers/10.1002/art.39048
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- Smith, M. T., Finan, P. H., Buenaver, L. F., Robinson, M., Haque, U., Quain, A., McInrue, E., Han, D., Leoutsakis, J., & Haythornthwaite, J. A. (2015). Cognitive–Behavioral Therapy for Insomnia in Knee Osteoarthritis: A Randomized, Double‐Blind, Active Placebo–Controlled Clinical Trial. Arthritis & Rheumatology. https://doi.org/10.1002/art.39048
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