CBT for Secondary Insomnia in Chronic Pain Patients

CBT 治疗慢性疼痛患者继发性失眠

• 批准号: 6935818
• 负责人: Michael Lloyd Perlis
• 金额: $ 19.47万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-15 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6935818
• 关键词: adult human (21+); backache; behavioral /social science research tag; behavioral medicine; chronic pain; clinical research; clinical trials; cognitive behavior therapy; depression; electrocardiography; electroencephalography; electromyography; human subject; human therapy evaluation; medical complication; nervous system disorder therapy; nurse practitioners; patient oriented research; polysomnography; quality of life; sleep deprivation; sleep disorders; therapy compliance

DESCRIPTION (provided by applicant): It is conservatively estimated that between 40 and 70 million people are affected by chronic pain and that nearly 90% of these patients complain of poor sleep. Despite high prevalence rates, very little clinical trial work has been undertaken in patients with insomnia secondary to chronic pain. We propose a preliminary study to evaluate whether CBT for insomnia can be successfully applied to insomnia secondary to chronic pain and to further assess whether clinical gains within the sleep domain are related to greater pain tolerance, improved mood and enhanced quality of life. Subjects with insomnia secondary to pain will be recruited to participate in a parallel-groups, randomized, single blind, "placebo" controlled trial. Subjects will be assigned to one of two groups: one receiving treatment (CBT for insomnia including sleep restriction, stimulus control, cognitive therapy and sleep hygiene), the other group receiving a non-active control for measurement and therapist contact time. Treatment will occur on an individual basis by a Nurse Practitioner trained in research grade CBT for Insomnia. Sleep, pain, mood and quality of life symptoms will be monitored for a 2-week baseline period, weekly during the treatment phase and for 2-week intervals at 3 and 6 months post treatment. The data obtained from this R21 will be used to create effect size estimates for 1) the efficacy of CBT-I in patients with insomnia secondary to chronic pain and 2) the effects of improved sleep continuity on pain, mood, and quality of life. It is anticipated, both on empirical and theoretical grounds, that CBT-I will produce moderate to large effects for both the primary and secondary outcome measures. If the project is successful, these data will be used as the basis for an R01 application. It is anticipated that studies of this kind will provide the kind of evidence required to make CBT-I a standard of practice for the management of chronic pain.

描述（由申请人提供）：保守估计，有 40 至 7000 万人受到慢性疼痛的影响，其中近 90% 的患者抱怨睡眠质量不佳。尽管患病率很高，但针对慢性疼痛继发失眠的患者进行的临床试验工作却很少。 我们提出了一项初步研究，以评估失眠认知行为治疗是否可以成功应用于慢性疼痛继发的失眠，并进一步评估睡眠领域的临床收益是否与增强疼痛耐受性、改善情绪和提高生活质量有关。 将招募继发于疼痛的失眠受试者参加平行组、随机、单盲、“安慰剂”对照试验。受试者将被分配到两组中的一组：一组接受治疗（针对失眠的 CBT，包括睡眠限制、刺激控制、认知治疗和睡眠卫生），另一组接受非主动控制以测量和治疗师接触时间。治疗将由接受过研究级失眠 CBT 培训的执业护士进行个体化治疗。睡眠、疼痛、情绪和生活质量症状将在两周基线期、治疗阶段每周一次以及治疗后 3 个月和 6 个月时每两周一次进行监测。 从 R21 获得的数据将用于创建效应大小估计：1) CBT-I 对慢性疼痛继发失眠患者的疗效，以及 2) 改善睡眠连续性对疼痛、情绪和生活质量的影响。根据经验和理论，预计 CBT-I 将对主要和次要结果指标产生中等到大的影响。如果项目成功，这些数据将作为 R01 申请的基础。预计此类研究将提供使 CBT-I 成为慢性疼痛管理实践标准所需的证据。

项目成果

The efficacy of cognitive-behavioral therapy for insomnia in patients with chronic pain.

认知行为疗法对慢性疼痛患者失眠的疗效。

• 发表时间: 2010-03
• 影响因子: 4.8
• 作者: Jungquist, Carla R;O'Brien, Chris;Matteson;Smith, Michael T;Pigeon, Wilfred R;Xia, Yinglin;Lu, Naiji;Perlis, Michael L
• 通讯作者: Perlis, Michael L

The durability of cognitive behavioral therapy for insomnia in patients with chronic pain.

认知行为疗法治疗慢性疼痛患者失眠的持久性。

• 发表时间: 2012
• 作者: Jungquist, Carla R;Tra, Yolande;Smith, Michael T;Pigeon, Wilfred R;Matteson;Xia, Yinglin;Perlis, Michael L
• 通讯作者: Perlis, Michael L