Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trial
Background: Comorbid sleep disturbances are common among individuals with chronic pain, and Cognitive Behavioural Therapy for Insomnia (CBT-i) has proven effective for such individuals. Nonetheless, research on web-based CBT-i tailored for patients with both chronic pain and insomnia is limited. Thi...
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Elsevier
2024-12-01
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| Series: | Internet Interventions |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214782924000745 |
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| author | K. Bothelius S. Jernelöv V. Kaldo C. Lu M.-M. Stråle M. Jansson-Fröjmark |
| author_facet | K. Bothelius S. Jernelöv V. Kaldo C. Lu M.-M. Stråle M. Jansson-Fröjmark |
| author_sort | K. Bothelius |
| collection | DOAJ |
| description | Background: Comorbid sleep disturbances are common among individuals with chronic pain, and Cognitive Behavioural Therapy for Insomnia (CBT-i) has proven effective for such individuals. Nonetheless, research on web-based CBT-i tailored for patients with both chronic pain and insomnia is limited. This study aimed to evaluate the feasibility and efficacy of internet-based CBT-i and to explore potential mechanisms underlying treatment outcomes. Methods: In this study, 85 participants suffering from comorbid insomnia and chronic pain were randomized into two groups: Internet-based CBT for Insomnia (ICBT-i) and Internet-based Applied Relaxation (IAR). Both interventions spanned eight weeks, supported by therapeutic guidance throughout. Results: Participation was modest, with an average module completion of 2.0 out of 8 for ICBT-i and 2.4 for IAR. Both interventions significantly alleviated insomnia symptoms on one of the insomnia measures post-treatment, without notable differences between them. Directly after treatment, IAR outperformed ICBT-i in reducing pain interference, anxiety, and in enhancing self-rated health, though these differences lessened at the 6-month follow-up. Potential therapeutic mechanisms may involve attenuating maladaptive sleep beliefs and augmenting sleep-related willingness. Conclusions: The study encountered low engagement rates, with approximately one-third of participants not completing any module. The limited efficacy of ICBT-i may be due to low treatment involvement, with few patients completing key techniques like sleep compression and stimulus control. Despite the low adherence, both interventions yielded post-treatment improvements in insomnia symptoms, but to establish internet-based treatments for insomnia as a viable option in chronic pain management, patient engagement must be improved. |
| format | Article |
| id | doaj-art-0e6058d5ab6f48aa9e977a64e854e3e0 |
| institution | Kabale University |
| issn | 2214-7829 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Internet Interventions |
| spelling | doaj-art-0e6058d5ab6f48aa9e977a64e854e3e02024-12-12T05:21:55ZengElsevierInternet Interventions2214-78292024-12-0138100781Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trialK. Bothelius0S. Jernelöv1V. Kaldo2C. Lu3M.-M. Stråle4M. Jansson-Fröjmark5Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Corresponding author at: Department of Surgical Sciences, Uppsala University, Akademiska sjukhuset, 751 85 Uppsala, Sweden.Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, SwedenDepartment of Psychology, Uppsala University, Uppsala, SwedenDepartment of Psychology, Uppsala University, Uppsala, SwedenCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, SwedenBackground: Comorbid sleep disturbances are common among individuals with chronic pain, and Cognitive Behavioural Therapy for Insomnia (CBT-i) has proven effective for such individuals. Nonetheless, research on web-based CBT-i tailored for patients with both chronic pain and insomnia is limited. This study aimed to evaluate the feasibility and efficacy of internet-based CBT-i and to explore potential mechanisms underlying treatment outcomes. Methods: In this study, 85 participants suffering from comorbid insomnia and chronic pain were randomized into two groups: Internet-based CBT for Insomnia (ICBT-i) and Internet-based Applied Relaxation (IAR). Both interventions spanned eight weeks, supported by therapeutic guidance throughout. Results: Participation was modest, with an average module completion of 2.0 out of 8 for ICBT-i and 2.4 for IAR. Both interventions significantly alleviated insomnia symptoms on one of the insomnia measures post-treatment, without notable differences between them. Directly after treatment, IAR outperformed ICBT-i in reducing pain interference, anxiety, and in enhancing self-rated health, though these differences lessened at the 6-month follow-up. Potential therapeutic mechanisms may involve attenuating maladaptive sleep beliefs and augmenting sleep-related willingness. Conclusions: The study encountered low engagement rates, with approximately one-third of participants not completing any module. The limited efficacy of ICBT-i may be due to low treatment involvement, with few patients completing key techniques like sleep compression and stimulus control. Despite the low adherence, both interventions yielded post-treatment improvements in insomnia symptoms, but to establish internet-based treatments for insomnia as a viable option in chronic pain management, patient engagement must be improved.http://www.sciencedirect.com/science/article/pii/S2214782924000745Cognitive behavioural therapy for insomniaChronic painInternet-based interventionsTreatment engagementSleep disturbancesMechanisms of improvement |
| spellingShingle | K. Bothelius S. Jernelöv V. Kaldo C. Lu M.-M. Stråle M. Jansson-Fröjmark Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trial Internet Interventions Cognitive behavioural therapy for insomnia Chronic pain Internet-based interventions Treatment engagement Sleep disturbances Mechanisms of improvement |
| title | Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trial |
| title_full | Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trial |
| title_fullStr | Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trial |
| title_full_unstemmed | Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trial |
| title_short | Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trial |
| title_sort | internet based cognitive behavioural therapy for insomnia comorbid with chronic benign pain a randomized controlled trial |
| topic | Cognitive behavioural therapy for insomnia Chronic pain Internet-based interventions Treatment engagement Sleep disturbances Mechanisms of improvement |
| url | http://www.sciencedirect.com/science/article/pii/S2214782924000745 |
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