Cited by 206Sleep and related disordersObstructive Sleep Apnea ResearchMusculoskeletal pain and rehabilitation

Cognitive behavioral therapy for insomnia in patients with chronic pain-A systematic review and meta-analysis of randomized controlled trials

Selvanathan, Janannii, Pham, Chi, Nagappa, Mahesh, Peng, Philip W.H., Englesakis, Marina, Espie, Colin A., Morin, Charles M., Chung, Frances·2021·Sleep Medicine Reviews

Abstract

Several randomized controlled trials have implemented cognitive behavioral therapy for insomnia (CBT-I) for patients with comorbid insomnia and chronic pain. This systematic review and meta-analysis investigated the effectiveness of CBT-I on patient-reported sleep, pain, and other health outcomes (depressive symptoms, anxiety symptoms, and fatigue) in patients with comorbid insomnia and chronic non-cancer pain. A systematic literature search was conducted using eight electronic databases. Upon duplicate removal, 6374 records were screened against the inclusion criteria. Fourteen randomized controlled trials were selected for the review, with twelve (N = 762 participants) included in the meta-analysis. At post-treatment, significant treatment effects were found on global measures of sleep (standardized mean difference = 0.89), pain (0.20), and depressive symptoms (0.44). At follow-up (up to 12 mo), CBT-I significantly improved sleep (0.56). Using global measures of sleep, we found a probability of 81% and 71% for having better sleep after CBT-I at post-treatment and final follow-up, respectively. The probability of having less pain after CBT-I at post-treatment and final follow-up was 58% and 57%, respectively. There were no statistically significant effects on anxiety symptoms and fatigue at either assessment point. Future trials with sufficient power, longer follow-up periods, and inclusion of CBT for pain components are warranted.

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Crossref · 10.1016/j.smrv.2021.101460

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Authors
Selvanathan, J., Pham, C., Nagappa, M., Peng, P. W. H., Englesakis, M., Espie, C. A., Morin, C. M., & Chung, F.
Affiliations
  • University Health Network (CA)
  • Western University (CA)
  • University of Oxford (GB)
  • Université Laval (CA)
Corresponding author
Chung, Frances
Venue
Sleep Medicine Reviews
Publisher
Elsevier BV
Published
2021-12
Volume
60
Pages
101460
ISSN
1087-0792 (ISSN-L)
OpenAlex
W3128925023
Cited by
206
References
85
Citations by year
2026: 35 · 2025: 47 · 2024: 35 · 2023: 44 · 2022: 31 · 2021: 13 · 2013: 1
FWCI
5.04
Type
journal article
Language
en
Open access
closed
Locations
  • Sleep Medicine Reviews (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
cognitive behavioral therapy for insomnia, insomnia, chronic non-cancer pain, sleep quality, pain intensity, depressive symptoms, anxiety symptoms, fatigue, treatment effectiveness
MeSH terms
Analgesics, Opioid, Humans, Sleep Initiation and Maintenance Disorders, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Chronic Pain

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