Behavioral Therapy Seen to Ease Insomnia in Patients with Chronic Pain

Behavioral Therapy Seen to Ease Insomnia in Patients with Chronic Pain

A study by researchers in the U.K. identified a correlation — and feedback loop — between chronic pain and lack of sleep, reporting that people with chronic pain due to conditions like fibromyalgia, and who believe that they will not be able to sleep, are more likely to suffer from insomnia episodes that further worsen their pain. They also developed a scale to measure the two simultaneously, because of the close relationship between pain and sleep.

The study, led by researchers with the Sleep and Pain Lab, part of the University of Warwick’s Department of Psychology, also suggests that cognitive-behavioral therapy can be used to effectively manage these conditions.

The findings were published in the Journal of Clinical Sleep Medicine, in the article “Development of the Pain-Related Beliefs and Attitudes about Sleep (PBAS) Scale for the Assessment and Treatment of Insomnia Comorbid with Chronic Pain.”

Chronic pain is known to affect the way patients approach sleep, often in negative ways. The researchers, using this knowledge, developed a scale to measure these patients’ beliefs about their sleep and pain levels, and their quality of sleep, called the Pain-Related Beliefs and Attitudes about Sleep (PBAS) scale.

To test the scale, investigators separated long-term pain patients into four groups. Results showed that people who thought a priori that they would not be able to sleep because of their pain were more likely to experience insomnia, and subsequently more pain.

The scale was able to predict patients’ level of insomnia and pain, and patients who slept better reported lesser difficulties with pain. A “short course” in cognitive-behavioral therapy was also reported to improve sleep and “significantly” reduce pain.

“Current psychological treatments for chronic pain have mostly focused on pain management and a lesser emphasis on sleep, but there is a recent interest in developing therapies to tackle both pain and sleep problems simultaneously. This scale provides a useful clinical tool to assess and monitor treatment progress during these therapies,” Esther Afolalu, the study’s lead investigator, said in a press release.