Treatment of Insomnia Secondary to Chronic Pain

慢性疼痛继发失眠的治疗

• 批准号: 7117611
• 负责人: Wilfred R Pigeon
• 金额: $ 5.2万
• 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: 2004-08-14 至 2007-08-13
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7117611
• 关键词: behavioral /social science research tag; behavioral medicine; chronic pain; clinical research; cognitive behavior therapy; electroencephalography; human subject; human therapy evaluation; medical complication; nervous system disorder epidemiology; nervous system disorder therapy; neuropsychology; outcomes research; patient oriented research; polysomnography; postdoctoral investigator; quality of life; questionnaires; sleep disorders

DESCRIPTION (provided by applicant): Chronic pain affects 40-70 million people with nearly 90% experiencing disturbed sleep. While it is plausible that insomnia occurring in association with chronic pain has the same etiologic factors that contribute to Primary Insomnia little work has been undertaken to determine whether cognitive-behavioral therapy for insomnia (CBT-I) can be successfully applied to insomnia secondary to chronic pain. We propose to address this issue and to further assess whether clinical gains within the sleep domain are related to greater pain tolerance, improved mood and enhanced quality of life. Twenty subjects with insomnia secondary to pain will complete a two-way, cross-over designed study following a polysomnography screen. Participants will be randomized to receive either CBT-I or CBT for pain (CBT-P) as the first of two treatments. Each treatment will occur with trained clinicians in 8 weekly, individual sessions. Sleep, pain mood and quality of life symptoms will be monitored for a 2 week baseline period, weekly during each treatment phase and for a 2 week interval at 3 months post treatment. The data obtained from this F32 will be used to create effect size estimates for 1) the efficacy of CBT-I vs CBT-P and 2) the effects of improved sleep continuity on pain, mood, and quality of life. A secondary aim is to profile and compare subjects' sleep architecture and quantitative sleep EEGs to archival data from patients with other insomnias and with Good Sleepers. It is anticipated, that CBT-I will product 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 R21 and/or a K23 application. Finally, it is anticipated that studies of this kind will provide the evidence required to make CBT-I a standard of practice for the management of chronic pain.

描述（由申请人提供）：慢性疼痛影响着 40-7000 万人，其中近 90% 的人经历过睡眠障碍。虽然与慢性疼痛相关的失眠可能与导致原发性失眠的病因相同，但目前还没有开展多少工作来确定失眠认知行为疗法 (CBT-I) 是否可以成功应用于继发于慢性疼痛的失眠。疼痛。我们建议解决这个问题，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。二十名因疼痛继发失眠的受试者将在多导睡眠图筛查后完成一项双向交叉设计的研究。参与者将被随机接受 CBT-I 或 CBT 疼痛治疗 (CBT-P) 作为两种治疗中的第一种。每次治疗均由训练有素的临床医生进行，每周 8 次，单独进行。将在 2 周基线期内监测睡眠、疼痛情绪和生活质量症状，在每个治疗阶段每周监测一次，并在治疗后 3 个月时监测间隔 2 周。从该 F32 获得的数据将用于创建效应大小估计：1) CBT-I 与 CBT-P 的功效以及 2) 改善的睡眠连续性对疼痛、情绪和生活质量的影响。第二个目标是将受试者的睡眠结构和定量睡眠脑电图与其他失眠症患者和良好睡眠者的档案数据进行分析和比较。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，这些数据将用作 R21 和/或 K23 应用程序的基础。最后，预计此类研究将提供所需的证据，使 CBT-I 成为慢性疼痛管理的实践标准。

项目成果

Is insomnia a perpetuating factor for late-life depression in the IMPACT cohort?

在 IMPACT 队列中，失眠是导致晚年抑郁症的永久因素吗？

• DOI: 10.1093/sleep/31.4.481
• 发表时间: 2008-04-01
• 期刊: Sleep
• 影响因子: 5.6
• 作者: W. Pigeon;M. Hegel;J. Unützer;Ming‐Yu Fan;M. Sateia;J. Lyness;Cindy Phillips;M. Perlis
• 通讯作者: M. Perlis