Comparison of behavioral therapies for female veterans experiencing insomnia and pain Original paper

In this randomized controlled trial, cognitive behavioral therapy and acceptance and commitment therapy both reduced pain symptoms in female veterans with insomnia and chronic pain.

This Study Summary was published on February 9, 2024.

Quick Summary

In this randomized controlled trial, cognitive behavioral therapy and acceptance and commitment therapy both reduced pain symptoms in female veterans with insomnia and chronic pain.

What was studied?

The effectiveness of cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT)* for reducing painvia treatment of insomnia.

Who was studied?

93 female veterans (average age of 47) who experienced both insomnia and chronic pain at a level of at least 1 on a 0-to-10 scale.

How was it studied?

In this randomized controlled trial, the participants were assigned to either a CBT or ACT program that was designed to treat insomnia. The researchers ensured that both groups had an equal distribution of participants with severe insomnia (defined as <6 hours of sleep per night).

The participants in both groups attended individual 60-minute sessions with trained therapists, once per week for 5 weeks. In these sessions, they learned how to apply behavioral strategies to address insomnia. The effectiveness of both treatments were evaluated using pain, sleep, and psychological questionnaires administered at baseline, immediately after the 5-week intervention, and at 3 months after the intervention.

What were the results?

The CBT and ACT treatments for insomnia were both associated with small decreases in pain. They were equally effective at reducing pain between the start of treatment and immediately after treatment. However, there was no additional pain reduction observed from the end of either treatment to 3 months later.

Both groups experienced similar improvements in psychological flexibility, which was described as the ability to be present in the moment even when difficult emotions arise. CBT was more effective at reducing dysfunctional beliefs about sleep than ACT was.

Anything else I need to know?

Chronic back pain, arthritis, and chronic headaches were the most common sources of pain experienced by the participants.

*The ACT group in this study followed a novel protocol called ABC (acceptance and behavioral changes for insomnia), which combined behavioral strategies such as stimulus control, sleep restriction, and sleep hygiene with ACT exercises.

This Study Summary was published on February 9, 2024.