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Treatment of Insomnia Secondary to Chronic Pain

慢性疼痛继发失眠的治疗

基本信息

批准号：
7117611
负责人：
Wilfred R Pigeon
金额：
$ 5.2万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-08-14 至 2007-08-13
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Chronic pain affects 40-70 million people with nearly 90% experiencing disturbed sleep. While it is plausible that insomnia occurring in association with chronic pain has the same etiologic factors that contribute to Primary Insomnia little work has been undertaken to determine whether cognitive-behavioral therapy for insomnia (CBT-I) can be successfully applied to insomnia secondary to chronic pain. We propose to address this issue and to further assess whether clinical gains within the sleep domain are related to greater pain tolerance, improved mood and enhanced quality of life. Twenty subjects with insomnia secondary to pain will complete a two-way, cross-over designed study following a polysomnography screen. Participants will be randomized to receive either CBT-I or CBT for pain (CBT-P) as the first of two treatments. Each treatment will occur with trained clinicians in 8 weekly, individual sessions. Sleep, pain mood and quality of life symptoms will be monitored for a 2 week baseline period, weekly during each treatment phase and for a 2 week interval at 3 months post treatment. The data obtained from this F32 will be used to create effect size estimates for 1) the efficacy of CBT-I vs CBT-P and 2) the effects of improved sleep continuity on pain, mood, and quality of life. A secondary aim is to profile and compare subjects' sleep architecture and quantitative sleep EEGs to archival data from patients with other insomnias and with Good Sleepers. It is anticipated, that CBT-I will product moderate to large effects for both the primary and secondary outcome measures. If the project is successful, these data will be used as the basis for an R21 and/or a K23 application. Finally, it is anticipated that studies of this kind will provide the evidence required to make CBT-I a standard of practice for the management of chronic pain.

描述(申请人提供)：慢性疼痛影响4,000-7,000万人，其中近90%经历睡眠障碍。虽然与慢性疼痛相关的失眠有可能与导致原发性失眠的病因相同，但几乎没有工作来确定认知行为疗法(CBT-I)是否能成功地应用于慢性疼痛继发失眠。我们建议解决这个问题，并进一步评估睡眠领域的临床收益是否与更强的疼痛耐受性、改善的情绪和提高的生活质量有关。20名患有疼痛继发失眠的受试者将在多导睡眠图筛查后完成一项双向、交叉设计的研究。参与者将随机接受CBT-I或CBT治疗疼痛(CBT-P)作为两种治疗中的第一种。每项治疗将在训练有素的临床医生的指导下进行，每周8次，单独进行。睡眠、疼痛情绪和生活质量症状将在两周的基准期内进行监测，在每个治疗阶段每周监测一次，并在治疗后3个月每隔两周监测一次。从F32获得的数据将被用来为1)CBT-I与CBT-P的疗效以及2)改善睡眠连续性对疼痛、情绪和生活质量的影响创建效应大小估计。第二个目标是描述受试者的睡眠结构和定量睡眠脑电，并将其与其他失眠症和睡眠良好者的档案数据进行比较。预计，CBT-I将对主要和次要结果衡量产生中等到较大的影响。如果项目成功，这些数据将被用作R21和/或K23应用的基础。最后，预计这类研究将提供所需的证据，使CBT-I成为慢性疼痛管理的实践标准。