Prevention of Pain Interference in Insomnia Patients via Digital Cognitive-Behavioral Therapy for Insomnia

Document Type

Article

Publication Date

5-5-2025

Publication Title

Behavioral sleep medicine

Abstract

OBJECTIVES: Insomnia disorder is co-morbid with and predictive of developing pain conditions and a key factor in pain interference (PI) - the extent to which pain impedes daily living. Emerging literature suggests treating insomnia with cognitive-behavioral therapy for insomnia reduces co-occurring PI. This secondary data analysis tested the extent to which digital CBT-I (dCBT-I) vs. sleep education reduces and prevents significant PI by treating insomnia.

METHODS: Insomnia disorder participants were randomized into dCBT-I (n = 697) and sleep education (n = 623) and reported pre- and post-treatment insomnia and PI. Logistic regressions evaluated intervention effects: 1) reduction of insomnia severity changes in PI and 2) prevention of treatment condition on PI.

RESULTS: The reduction model showed that dCBT-I participants with moderate-to-severe pre-treatment PI experienced 17% odds increase in reduced PI for each one-point reduction in insomnia severity compared to control, OR = 1.17, 95% CI [1.01, 1.35]. In the prevention model, dCBT-I participants with little-to-no pre-treatment PI exhibited a 32% odds reduction of post-treatment progression to moderate-to-severe PI compared to control, OR = 0.68, 95% CI [0.51, 0.90].

CONCLUSION: dCBT-I demonstrated significant and clinically meaningful reduction and prevention effects against PI in a large sample. dCBT-I may help providers address sleep issues to restore pain-related impairments to daytime function, quality of life, and overall sleep.

Medical Subject Headings

Humans; Sleep Initiation and Maintenance Disorders/therapy/complications; Cognitive Behavioral Therapy/methods; Male; Female; Middle Aged; Pain/prevention & control/complications; Adult; Treatment Outcome; Pain Management/methods

PubMed ID

40324067

ePublication

ePub ahead of print

Volume

23

Issue

5

First Page

593

Last Page

605

Find It @ Sladen

Share

COinS