Clinical significance and predictors of treatment response to cognitive-behavior therapy for insomnia secondary to chronic pain
Abstract
We examined individual responses to cognitive-behavior therapy for insomnia in 51 persons with chronic pain to determine the rate of clinically significant change and to identify predictors of successful treatment response. Outcome measures consisted of the Pittsburgh Sleep Quality Index (PSQI) and diary measures of sleep latency and sleep continuity. Using reliable change indices, 57% of participants were statistically improved on the PSQI after 7 weeks of treatment, but only 18% were considered fully recovered from their sleep problems. No demographic variables predicted treatment response but persons who reliably improved on the PSQI had a lower sleep self-efficacy at baseline. Improvers showed a significant increase in sleep self-efficacy ratings and a decrease in self-reported levels of distress and pain-related disability. These results suggest that patients with insomnia secondary to chronic medical conditions can be helped with cognitive-behavior therapy, although most individuals continue to have mild or subthreshold sleep problems at posttreatment.
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The effect sizes for improvements in sleep duration and subjective sleep quality in this study were similar to or greater than those reported for cognitive behavioral intervention and other physical activity studies.
“The effect size for the improvements in sleep duration and subjective sleep quality in this study were similar or even greater than that reported for cognitive behavioral intervention and other physical activity studies [18, 30, 36-38].”
From Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia (2010) · cites this paper as [36]
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“Similarly, in the Canadian population, the prevalence of mood disorders in those experiencing persistent low back pain was 19.8% (Currie et al. 2002 ) .”
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TRATAMIENTO PSICOLÓGICO DEL INSOMNIO EN LA FIBROMIALGIA Y OTROS SÍNDROMES DE DOLOR CRÓNICO
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- Authors
- Currie, S. R., Wilson, K. G., & Curran, D.
- Affiliations
- University of Ottawa (CA)
- University of Calgary (CA)
- Corresponding author
- Currie, Shawn R.
- Venue
- Journal of Behavioral Medicine
- Published
- 2002-04
- Volume
- 25
- Issue
- 2
- Pages
- 135-153
- ISSN
- 0160-7715 (ISSN-L)
- 1573-3521
- OpenAlex
- W1521059902
- Cited by
- 100
- References
- 37
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 6 · 2022: 1 · 2021: 6 · 2020: 4 · 2019: 5 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 5 · 2014: 9 · 2013: 10 · 2012: 3
- FWCI
- 2.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cognitive behavioral therapy for insomnia, chronic pain, predictors of treatment response, Pittsburgh Sleep Quality Index, sleep latency, sleep continuity, pain-related disability, distress, reliable change index
- MeSH terms
- Adult, Analysis of Variance, Chronic Disease, Female, Follow-Up Studies, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Pain, Psychotherapy, Brief, Surveys and Questionnaires, Sampling Studies, Sleep, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome
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