Randomized Controlled Pilot Trial of Behavioral Insomnia Treatment for Chronic Migraine With Comorbid Insomnia
Abstract
Background Migraine frequently co-occurs with and is triggered by sleep disturbance, particularly insomnia, and the large majority of patients with chronic migraine (CM) have comorbid insomnia. Limited evidence suggests that behavioral regulation of sleep may reduce migraine frequency, but studies to date have not assessed the viability of stimulus control and sleep restriction interventions or included objective measurement of sleep parameters. The aim of this study, thus, was to pilot-test the efficacy of a brief behavioral insomnia intervention for adults with CM and comorbid insomnia; headache diaries and actigraphy were included to assess outcomes throughout the trial. Methods This randomized parallel-arm pilot trial recruited adults with both CM and comorbid insomnia. Participants were randomly assigned to three 30-minute biweekly sessions of cognitive-behavioral therapy for insomnia (CBTi) or control treatment. Participants were blinded to treatment and control conditions to control for outcome expectations. Each treatment condition involved training in and daily practice in 5 instructions/skills. The CBTi group learned and practiced skills pertaining to stimulus control and sleep restriction. The control intervention was the same as used by Calhoun and Ford (2007) and involved training in and daily practice of skills pertaining to keeping a consistent food/liquid intake, range of motion exercises, and acupressure. Participants provided outcome data via daily headache…
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The study's findings on long-term disability and quality of life gains lend support to the theoretical framework of ACT and ACT for pain approach, particularly that symptom changes may not be needed for a person to live a functional and valued life.
“This study's findings on long-term disability and quality of life gains lend support to the theoretical framework of ACT and ACT for pain approach particularly, in that symptom changes may not be needed in order for a person to live a functional and valued life.”
From Acceptance and Commitment Therapy for Primary Headache Sufferers: A Randomized Controlled Trial of Efficacy (2021) · cites this paper as [67]
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- Authors
- Smitherman, T. A., Walters, A. B., Davis, R. E., Ambrose, C. E., Roland, M., Houle, T. T., & Rains, J. C.
- Affiliations
- University of Mississippi (US)
- Oxford Neurology Clinic Oxford MS USA
- Wake Forest University Health Sciences (US)
- Elliot Hospital (US)
- Corresponding author
- Smitherman, Todd A.
- Venue
- Headache: The Journal of Head and Face Pain
- Publisher
- Wiley
- Published
- 2016-01-27
- Volume
- 56
- Issue
- 2
- Pages
- 276-291
- ISSN
- 0017-8748 (ISSN-L)
- 1526-4610
- OpenAlex
- W2257174902
- Cited by
- 121
- References
- 19
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 18 · 2023: 8 · 2022: 20 · 2021: 15 · 2020: 12 · 2019: 6 · 2018: 11 · 2017: 4 · 2016: 6
- FWCI
- 12.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Headache The Journal of Head and Face Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Keywords
- chronic migraine, comorbid insomnia, cognitive behavioral therapy for insomnia, stimulus control, sleep restriction, headache frequency, sleep disorders, actigraphy, headache diary, acupressure, range of motion exercises, brief behavioral intervention, treatment credibility, migraine prophylaxis, treatment effect size, perceived credibility, perceived acceptability, perceived feasibility
- MeSH terms
- Adolescent, Adult, Behavior Therapy, Chronic Disease, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Migraine Disorders, Patient Compliance, Pilot Projects, Psychiatric Status Rating Scales, Surveys and Questionnaires, Severity of Illness Index, Treatment Outcome, Young Adult
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