Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Sleep Res. 2024 Oct;33(5):e14147. doi: 10.1111/jsr.14147. Epub 2024 Jan 21.
Insomnia and pain disorders are among the most common conditions affecting United States adults and veterans, and their comorbidity can cause detrimental effects to quality of life among other factors. Cognitive behavioural therapy for insomnia and related behavioural therapies are recommended treatments for insomnia, but chronic pain may hinder treatment benefit. Prior research has not addressed how pain impacts the effects of behavioural insomnia treatment in United States women veterans. Using data from a comparative effectiveness clinical trial of two insomnia behavioural treatments (both including sleep restriction, stimulus control, and sleep hygiene education), we examined the impact of pain severity and pain interference on sleep improvements from baseline to post-treatment and 3-month follow-up. We found no significant moderation effects of pain severity or interference in the relationship between treatment phase and sleep outcomes. Findings highlight opportunities for using behavioural sleep interventions in patients, particularly women veterans, with comorbid pain and insomnia, and highlight areas for future research.
失眠和疼痛障碍是影响美国成年人和退伍军人的最常见疾病之一,它们的共病可能会对生活质量等因素产生不利影响。认知行为疗法治疗失眠症和相关的行为疗法是失眠症的推荐治疗方法,但慢性疼痛可能会阻碍治疗效果。先前的研究尚未解决疼痛如何影响美国女性退伍军人行为性失眠治疗效果的问题。本研究使用两项失眠行为治疗(均包括睡眠限制、刺激控制和睡眠卫生教育)的比较有效性临床试验数据,考察了疼痛严重程度和疼痛干扰对从基线到治疗后和 3 个月随访期间睡眠改善的影响。我们发现,疼痛严重程度或干扰在治疗阶段与睡眠结果之间的关系中没有显著的调节作用。研究结果突出了在患有疼痛和失眠共病的患者(尤其是女性退伍军人)中使用行为睡眠干预的机会,并强调了未来研究的方向。