Wanberg Lindsey J, Thomas S Justin, Reid Michelle, Rottapel Rebecca, von Ash Tayla, Jones Nicole, Brar Laurie, Beidas Rinad, Rueschman Michael, Edwards Robert R, Buysse Daniel J, Redline Susan, Bertisch Suzanne M
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston.
Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham.
Behav Sleep Med. 2023 May-Jun;21(3):273-290. doi: 10.1080/15402002.2022.2082429. Epub 2022 Jun 6.
Insomnia is highly prevalent among persons with chronic pain. Although cognitive behavioral therapy for insomnia is recommended as first-line treatment for insomnia, it is underutilized. We tested the feasibility of a potentially scalable alternative - Brief Behavioral Therapy for Insomnia (BBTI) for former National Football League (NFL) players, a group with a high prevalence of chronic pain. We assessed changes in sleep, pain, and psychological health.
Single-arm clinical trial of an adapted telephone-delivered BBTI intervention in 40 former NFL players with insomnia. We collected data on changes in sleep, pain, and psychological health outcomes.
Among former players (30% racial/ethnic minorities), BBTI was both acceptable and feasible. BBTI was associated with improvements in sleep disturbance (primary exploratory sleep outcome, mean T-score change -6.2, 95% CI: -7.6, -4.8), sleep-related impairment (mean T-score change -5.7, 95% CI: -7.9, -3.5) and insomnia severity (mean change -5.3, 95% CI: -6.8, -3.5) post-intervention. Improvements were maintained at 2-months. BBTI was also associated with improvements in pain interference and intensity, but not psychological health.
An adapted telephone-delivered BBTI is acceptable and feasible among retired players with a range of insomnia symptoms and shows promise for improving sleep and pain. These data support the need for future trials assessing BBTI's effect on both sleep and pain outcomes.
失眠在慢性疼痛患者中极为普遍。尽管失眠的认知行为疗法被推荐为失眠的一线治疗方法，但该疗法并未得到充分利用。我们测试了一种可能具有可扩展性的替代方法——针对前美国国家橄榄球联盟（NFL）球员的失眠简短行为疗法（BBTI）的可行性，这是一个慢性疼痛患病率很高的群体。我们评估了睡眠、疼痛和心理健康方面的变化。
对40名患有失眠的前NFL球员进行了一项采用电话方式实施的适应性BBTI干预的单臂临床试验。我们收集了睡眠、疼痛和心理健康结果变化的数据。
在前球员（30%为少数族裔）中，BBTI既可以接受又可行。BBTI与干预后睡眠障碍（主要探索性睡眠结果，平均T评分变化 -6.2，95%置信区间：-7.6，-4.8）、睡眠相关损害（平均T评分变化 -5.7，95%置信区间：-7.9，-3.5）和失眠严重程度（平均变化 -5.3，95%置信区间：-6.8，-3.5）的改善相关。改善情况在2个月时得以维持。BBTI还与疼痛干扰和强度的改善相关，但与心理健康无关。
一种采用电话方式实施的适应性BBTI在有一系列失眠症状的退休球员中是可以接受且可行的，并且在改善睡眠和疼痛方面显示出前景。这些数据支持未来进行评估BBTI对睡眠和疼痛结果影响的试验的必要性。
