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How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature
Abstract
Sleep disturbance is perhaps one of the most prevalent complaints of patients with chronically painful conditions. Experimental studies of healthy subjects and cross-sectional research in clinical populations suggest the possibility that the relationship between sleep disturbance and pain might be reciprocal, such that pain disturbs sleep continuity/quality and poor sleep further exacerbates pain. This suggests that aggressive management of sleep disturbance may be an important treatment objective with possible benefits beyond the improvement in sleep. Little is known, however, about how to effectively treat sleep disturbance associated with pain or whether such treatment might have beneficial effects on reducing pain. A small, but growing literature has applied cognitive-behavioral therapies (CBT) for either pain management or insomnia to patients with chronic pain. In this article, we review the longitudinal literature on sleep disturbance associated with chronic pain and clinical trial literatures of cognitive-behavior therapy for pain management and insomnia secondary to chronic pain with the aim of evaluating whether the relationship between clinical pain and insomnia is reciprocal. While methodological problems are common, the literature suggests that the relationship is reciprocal and CBT treatments for pain or insomnia hold promise in reducing pain severity and improving sleep quality. Directions for future research include the use of validated measures of sleep, longitudinal studies, and larger randomized clinical trials incorporating appropriate attentional controls and longer periods of follow-up.
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“Dysfunction in the physiology of sleep is common in those suffering from chronic pain (Smith and Haythornthwaite, 2004).”
From Self-management strategies to consider to combat endometriosis symptoms during the COVID-19 pandemic (2020) · cites this paper as Smith and Haythornthwaite, 2004
In the citing paper
“Sleep disorders are among the most common concerns related to pain [73].”
From ACTsmart: Guided Smartphone-Delivered Acceptance and Commitment Therapy for Chronic Pain—A Pilot Trial. (2021) · cites this paper as [73]
In the citing paper
“between 50% and 88% of patients with chronic pain report problems with sleep (Smith & Haythornthwaite, 2004).”
From Hypnotic approaches for chronic pain management: Clinical implications of recent research findings. (2014) · cites this paper as Smith & Haythornthwaite, 2004
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“It is understandable that employees who experienced pain, 47 in the form of back pain, arthritis, or migraines, would have more trouble sleeping than other employees.”
Glette, M., Landmark, T., Jensen, M. P., Woodhouse, A., Butler, S., Borchgrevink, P. C., & Stiles, T. C. (2018) · Journal of Pain · doi:10.1016/j.jpain.2018.03.010 · Cited by 13
Aaron, R. V., Noel, M. E., Dudeney, J. E., Wilson, A. C., Holley, A. L., & Palermo, T. M. (2019) · Journal of Behavioral Medicine · doi:10.1007/s10865-019-00016-5 · Cited by 13
Lillis, T. A., Burns, J. W., Aranda, F., Burgess, H. J., Purim-Shem-Tov, Y. A., Bruehl, S. P., Beckham, J. C., Pinkerton, L. M., & Hobfoll, S. E. (2019) · Journal of Behavioral Medicine · doi:10.1007/s10865-019-00123-3 · Cited by 12
Neilson, B. D., Shepherd, M. H., Dickerson, C., Chaconas, E. J., Young, J. L., & Rhon, D. I. (2022) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001051 · Cited by 12
Whale, K., & Gooberman‐Hill, R. (2022) · Trials · doi:10.1186/s13063-022-06584-3 · Cited by 13
Andrés, J. A. D., de la Calle, J. L., Pérez, M., & López, V. (2014) · Pain Research and Treatment · doi:10.1155/2014/518716 · Cited by 12
Sleep in Children Who Have Cancer
Rosen, G. M. (2007) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2007.05.011 · Cited by 12
Comparison of Sleep Problems in Individuals with Spinal Cord Injury and Multiple Sclerosis
Fogelberg, D. J., Hughes, A. J., Vitiello, M. V., Hoffman, J. M., & Amtmann, D. (2016) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.5798 · Cited by 12
Journal of Sleep Disorders & Therapy
(2020) · doi:10.35248/2167-0277 · Cited by 12
Mahoney, C. T., Shayani, D. R., & Iverson, K. M. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114641 · Cited by 12
The top 100 most cited papers in insomnia: A bibliometric analysis
Wan, Q., Liu, K., Wang, X., Luo, S., Yuan, X., Wang, C., Jiang, J., & Wu, W. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1040807 · Cited by 12
“33 Smith and Haythornthwaite (40) Sleep Medicine Reviews How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature 543 28.”
BackgroundInfluentialMapping the associations of daily pain, sleep, and psychological distress in a U.S. sample
Anderson, A. R., & Holliday, D. (2023) · Journal of Behavioral Medicine · doi:10.1007/s10865-023-00432-8 · Cited by 11
“Over half, and as many as 88% of individuals with chronic pain complain of sleep problems (Smith & Haythornthwaite, 2004 ), while about half of those with chronic pain report insomnia (Mathias et al., 2018 ).”
BackgroundLin, C., Lin, K., Hsueh, M., & Liao, Y. (2023) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2023.08.001 · Cited by 11
de Salas-Cansado, M., Pérez, C., Saldaña, M. T., Navarro, A. M., & Rejas, J. (2012) · Pain Medicine · doi:10.1111/j.1526-4637.2012.01375.x · Cited by 11
Soares, F. F. C., Ferreira, D. M. A. O., Raimundini, A. A., Dionísio, T. J., dos Santos, C. F., Conti, P. C. R., Costa, Y. M., & Bonjardim, L. R. (2022) · Journal of Oral Rehabilitation · doi:10.1111/joor.13384 · Cited by 11
Yabe, Y., Hagiwara, Y., Sugawara, Y., & Tsuji, I. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-022-06106-x · Cited by 8
“[37] In addition, brain structure controlling nociception modulates sleep states, [38] and pain and sleep disturbance can occur due to a common neurobiological dysfunction.”
BackgroundKaya, E., KAPLAN, C., ÇARLI, A. B., & GÜZELKÜÇÜK, Ü. (2016) · Archives of Rheumatology · doi:10.5606/archrheumatol.2016.4625 · Cited by 11
Integrative Medicine for the Treatment of Persistent Pain
Hillinger, M. G., Wolever, R. Q., McKernan, L. C., & Elam, R. O. (2017) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2017.02.008 · Cited by 11
“Compared with control interventions, strong RCTs demonstrate that CBT-I improves insomnia secondary to chronic pain in pain disorders other than fibromyalgia.(66,67) Similarly, CBT for pain improves sleep disorders.”
BackgroundOjeda, B. S., Salazar, A., Calahorro, M. J., Dueñas, M., Micó, J. A., Sola, H. D., & Failde, I. (2017) · Current Medical Research and Opinion · doi:10.1080/03007995.2017.1384372 · Cited by 11
Comparative effect of driving side on low back pain due to Repetitive Ipsilateral Rotation
Arslan, S. A., Hadian, M. R., Olyaei, G., Talebian, S., Yekaninejad, M. S., & Hussain, M. A. (2019) · Pakistan Journal of Medical Sciences · doi:10.12669/pjms.35.4.488 · Cited by 11
Alexandre, C., Latrémolière, A., & Finan, P. H. (2020) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190860509.013.31 · Cited by 11
Curatolo, P., & Moavero, R. (2021) · Nutrients · doi:10.3390/nu13051631 · Cited by 6
“A meta-analysis revealed that the presence of insomnia increased the risk of headache, and also of chronic pain worsening the long-term prognosis [17].”
BackgroundAhmed, A., Anand, A. N., Shah, I., Yakah, W., Freedman, S. D., THOMAS, R. J., & Sheth, S. G. (2022) · Sleep And Breathing · doi:10.1007/s11325-021-02541-7 · Cited by 11
Prevalence, Impact, and Trajectories of Sleep Disturbance in Cardiac Rehabilitation
Tighe, C. A., Buysse, D. J., Weiner, D. K., Beehler, G. P., & Forman, D. E. (2022) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000694 · Cited by 11
Binder, A., Rogers, P. D., Hans, G. H., & Baron, R. (2016) · Pain Management · doi:10.2217/pmt-2015-0010 · Cited by 11
Sadosky, A., Parsons, B., Emir, B., & Nieshoff, E. C. (2016) · Journal of Pain Research · doi:10.2147/jpr.s97770 · Cited by 11
Metadata
- Authors
- Smith, M. T., & Haythornthwaite, J. A.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Smith, Michael T
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2004-04
- Volume
- 8
- Issue
- 2
- Pages
- 119-132
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2167864730
- Cited by
- 914
- References
- 95
- Citations by year
- 2026: 38 · 2025: 44 · 2024: 33 · 2023: 52 · 2022: 54 · 2021: 61 · 2020: 59 · 2019: 58 · 2018: 55 · 2017: 58 · 2016: 64 · 2015: 64 · 2014: 52 · 2013: 33 · 2012: 41
- FWCI
- 2.54
- 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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- sleep disorders, chronic pain, insomnia, cognitive behavioral therapy for insomnia, pain management, sleep quality, longitudinal study
- MeSH terms
- Chronic Disease, Clinical Trials as Topic, Humans, Pain, Sleep Wake Disorders, Cognitive Behavioral Therapy, Pain Management
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