(Ivanhoe Newswire) – A new study shows the use of cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for older patients with osteoarthritis and the attendant pain which causes insomnia.
According to the study, sleep quality is a major concern for people with osteoarthritis, with 60 percent of people with the disease reporting pain during the night. Chronic pain initiates and exacerbates sleep disturbance; disturbed sleep in turn maintains and exacerbates chronic pain and related dysfunction.
Results showed treatment improved both immediate and long-term self-reported sleep and pain in older patients with osteoarthritis and insomnia without directly addressing pain control. Participants who received CBT-I reported significantly decreased sleep loss and wake after sleep onset. The treatment also significantly reduced pain and increased sleep efficiency. These improvements persisted in 19 of 23 CBT-I patients who were further assessed for sleep quality and perceived pain at a one-year follow-up visit.
According to lead author Michael V. Vitiello, PhD, professor at
the University of Washington in Seattle, Wash., results indicate
that insomnia is not merely a symptom of osteoarthritis, but rather
a co-existing illness. Vitiello said improving sleep can result in
an improvement in osteoarthritis, which is particularly important
because, at least in older adults, insomnia rarely exists by
itself, rather it typically coexists with other illness, pain
conditions and depression. "The particular strength of CBT-I is
that once an individual learns how to improve their sleep, study
after study has shown that the improvement persists for a year or
more," Vitello was quoted as saying. "What we and others are
showing is that CBT-I can not only improve sleep but that
improvement of sleep may lead to improvement in co-existing medical
or psychiatric illnesses, such as osteoarthritis or depression, and
in the case of our study, that these additional benefits can be
seen in the long term."
Twenty-three patients with a mean age of 69 years were
randomly assigned to CBT-I, while 28 patients with a mean age of
66.5 years were assigned to a stress management and wellness
control group. Participants in the control group who did not
receive CBT-I reported no significant improvements.
