How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature

Research output: Contribution to journalArticle

Abstract

Sleep disturbance is perhaps one of the most prevalent complaints of patients with chronically painful conditions. Experimental studies of healthy subjects and cross-sectional research in clinical populations suggest the possibility that the relationship between sleep disturbance and pain might be reciprocal, such that pain disturbs sleep continuity/quality and poor sleep further exacerbates pain. This suggests that aggressive management of sleep disturbance may be an important treatment objective with possible benefits beyond the improvement in sleep. Little is known, however, about how to effectively treat sleep disturbance associated with pain or whether such treatment might have beneficial effects on reducing pain. A small, but growing literature has applied cognitive-behavioral therapies (CBT) for either pain management or insomnia to patients with chronic pain. In this article, we review the longitudinal literature on sleep disturbance associated with chronic pain and clinical trial literatures of cognitive-behavior therapy for pain management and insomnia secondary to chronic pain with the aim of evaluating whether the relationship between clinical pain and insomnia is reciprocal. While methodological problems are common, the literature suggests that the relationship is reciprocal and CBT treatments for pain or insomnia hold promise in reducing pain severity and improving sleep quality. Directions for future research include the use of validated measures of sleep, longitudinal studies, and larger randomized clinical trials incorporating appropriate attentional controls and longer periods of follow-up.

Original languageEnglish (US)
Pages (from-to)119-132
Number of pages14
JournalSleep Medicine Reviews
Volume8
Issue number2
DOIs
StatePublished - Apr 2004

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Chronic Pain
Sleep
Clinical Trials
Pain
Sleep Initiation and Maintenance Disorders
Cognitive Therapy
Pain Management
Longitudinal Studies
Healthy Volunteers
Therapeutics
Randomized Controlled Trials
Research

Keywords

  • Chronic pain
  • Clinical trials
  • Cognitive-behavior therapy
  • Insomnia
  • Pain
  • Sleep

ASJC Scopus subject areas

  • Clinical Neurology
  • Dentistry(all)
  • Ophthalmology
  • Pulmonary and Respiratory Medicine
  • Neurology

Cite this

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