The University of Rochester Medical Center issued the following news release:

Cognitive behavioral therapy for insomnia significantly improved sleep
for patients with chronic neck or back pain and also reduced the extent
to which pain interfered with their daily functioning, according to a
study by University of Rochester Medical Center researchers.

The study, published online by the journal Sleep Medicine, demonstrates
that a behavioral intervention can help patients who already are taking
medications for pain and might be reluctant or unable to take additional
drugs to treat sleep disturbance.

“This therapy made a major difference to these patients,” said Carla R.
Jungquist, F.N.P., Ph.D., of the Medical Center’s Sleep and
Neurophysiology Research Laboratory, who is the lead author of the Sleep
Medicine article.

“We saw very good treatment effects.”

For the study, a nurse therapist delivered the eight weeks of cognitive
behavioral therapy, which included sleep restriction, stimulus control,
sleep hygiene, and one session devoted to discussion of catastrophic
thoughts about the consequences of insomnia.

“This study really shows that this therapy can be delivered successfully
and very effectively by advance practice nurses,” Jungquist said.

“Training nurses in the delivery of this type of therapy will result in
better access for patients. Currently, access to this therapy is limited
as there are few trained therapists and most are psychologists.”

Patients with chronic pain often use sleep as an escape.

They seek sleep when not sleepy, sleep in places other than the bedroom,
and engage in non-sleep behaviors, such as watching television and
resting a painful back, in the bedroom, the researchers report.

Using behavioral therapy instead of adding to their list of medications
is a healthier and safer method of treating sleep disturbance, Jungquist said.

“We establish a structure for the times or hours spent in bed,”
Jungquist explained.

“We focus on a patient’s negative thoughts about sleep and address
unhealthy sleep behavior. We address habits, including use of caffeine
or alcohol. We tell people to do nothing in bed except sleep or sex.”

Twenty-eight patients took part in the study. They were tracked through
detailed sleep diaries. Their pain and mood were measured using several
standard methods throughout the study period.

The patients were followed for six months after treatment. Researchers
expect to report soon on the duration of the effects of the treatment.

The researchers believe that cognitive behavioral therapy is as
effective as other tested treatments for insomnia and chronic pain and,
in some cases, is more effective than other therapies.

The researchers have developed a unique, user-friendly manual that
described each step of every treatment session. It can be used to train
more therapists.

The study, published online this month, was funded by the National
Institute of Nursing Research.

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