Cited by 914Sleep and related disordersMusculoskeletal pain and rehabilitationObstructive Sleep Apnea Research

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How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature

Smith, Michael T, Haythornthwaite, Jennifer A·2004·Sleep Medicine Reviews

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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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Authors: Smith, M. T., & Haythornthwaite, J. A.
Affiliations: Johns Hopkins University (US)
Corresponding author: Smith, Michael T
ORCID: Smith, Michael T
Haythornthwaite, Jennifer A
Venue: Sleep Medicine Reviews
Publisher: Elsevier BV
Published: 2004-04
Volume: 8
Issue: 2
Pages: 119-132
ISSN: 1087-0792 (ISSN-L)
DOI: 10.1016/s1087-0792(03)00044-3
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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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How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature

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