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. 2020 Jun;43(3):503-510.
doi: 10.1007/s10865-019-00065-w. Epub 2019 May 31.

Do treatment effects of a web-based cognitive behavioral therapy for insomnia intervention differ for users with and without pain interference? A secondary data analysis

Kelly M Shaffer  1   2 , Fabian Camacho  3 , Holly R Lord  3 , Philip I Chow  3 , Tonya Palermo  4 , Emily Law  4 , Frances P Thorndike  5 , Karen S Ingersoll  3 , Lee M Ritterband  3
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Do treatment effects of a web-based cognitive behavioral therapy for insomnia intervention differ for users with and without pain interference? A secondary data analysis

Kelly M Shaffer et al. J Behav Med. 2020 Jun.

Abstract

Cognitive-behavioral therapy for insomnia (CBT-I) shows treatment benefits among individuals with pain interference; however, effects of Internet-delivered CBT-I for this population are unknown. This secondary analysis used randomized clinical trial data from adults assigned to Internet-delivered CBT-I to compare changes in sleep by pre-intervention pain interference. Participants (N = 151) completed the Insomnia Severity Index (ISI) and sleep diaries [sleep onset latency (SOL); wake after sleep onset (WASO)] at baseline, post-assessment, 6- and 12-month follow-ups. Linear mixed-effects models showed no differences between pain interference groups (no, some, moderate/severe) for changes from baseline to any follow-up timepoint for ISI (p = .72) or WASO (p = .88). There was a small difference in SOL between those reporting some versus no or moderate/severe pain interference (p = .04). Predominantly comparable and sustained treatment benefits for both those with and without pain interference suggest that Internet-delivered CBT-I is promising for delivering accessible care to individuals with comorbid pain and insomnia.

Keywords: Cognitive behavioral therapy; Comorbidity; Insomnia; Internet; Pain interference.

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Conflict of interest statement

Conflicts: Shaffer, Camacho, Lord, Chow, Palermo, Law, and Ingersoll have no conflicts of interest to disclose. Thorndike and Ritterband report having equity ownership in BeHealth Solutions, LLC, a company that develops and makes available products related to the research reported in this article. Specifically, BeHealth Solutions, LLC, has licensed the Sleep Healthy Using the Internet (SHUTi) program and the software platform on which it was built from the University of Virginia. The terms of this arrangement have been reviewed and approved by the University of Virginia in accord with its conflict of interest policy.

Figures

Figure 1:
Figure 1:
Interaction Plots of Sleep Outcomes among Participants Assigned to SHUTi by Pain Interference Group
See this image and copyright information in PMC

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