Finan Patrick H, Buenaver Luis F, Coryell Virginia T, Smith Michael T
Sleep Med Clin. 2014 Jun 1;9(2):261-274. doi: 10.1016/j.jsmc.2014.02.007.
This article summarizes the literature on cognitive-behavioral therapy for insomnia (CBT-I) in patients with comorbid insomnia and chronic pain. An empirical rationale for the development of CBT-I in chronic pain is provided. The six randomized controlled trials in this area are described and contrasted. The data suggest that CBT-I for patients with comorbid insomnia and chronic pain produces clinically meaningful improvements in sleep symptoms. Effects on pain are inconsistent, but tend to favor functional measures over pain severity. Hybrid interventions for insomnia and pain have demonstrated feasibility, but larger trials must be conducted to determine efficacy relative to CBT-I alone. Future efforts should employ more comprehensive assessments of pain and psychosocial factors.
本文总结了有关共病失眠和慢性疼痛患者的失眠认知行为疗法（CBT-I）的文献。提供了在慢性疼痛中开展CBT-I的实证依据。描述并对比了该领域的六项随机对照试验。数据表明，针对共病失眠和慢性疼痛患者的CBT-I能在睡眠症状方面产生具有临床意义的改善。对疼痛的影响并不一致，但倾向于在功能指标方面而非疼痛严重程度方面表现出优势。针对失眠和疼痛的混合干预措施已证明具有可行性，但必须开展更大规模的试验以确定相对于单纯CBT-I的疗效。未来的研究应采用更全面的疼痛和心理社会因素评估方法。
