Behavioral insomnia therapy for fibromyalgia patients: a randomized clinical trial.

Published

Journal Article

BACKGROUND: Insomnia is common and debilitating to fibromyalgia (FM) patients. Cognitive-behavioral therapy (CBT) is effective for many types of patients with insomnia, but has yet to be tested with FM patients. This study compared CBT with an alternate behavioral therapy and usual care for improving sleep and other FM symptoms. METHODS: This randomized clinical trial enrolled 47 FM patients with chronic insomnia complaints. The study compared CBT, sleep hygiene (SH) instructions, and usual FM care alone. Outcome measures were subjective (sleep logs) and objective (actigraphy) total sleep time, sleep efficiency, total wake time, sleep latency, wake time after sleep onset, and questionnaire measures of global insomnia symptoms, pain, mood, and quality of life. RESULTS: Forty-two patients completed baseline and continued into treatment. Sleep logs showed CBT-treated patients achieved nearly a 50% reduction in their nocturnal wake time by study completion, whereas SH therapy- and usual care-treated patients achieved only 20% and 3.5% reductions on this measure, respectively. In addition, 8 (57%) of 14 CBT recipients met strict subjective sleep improvement criteria by the end of treatment compared with 2 (17%) of 12 SH therapy recipients and 0% of the usual care group. Comparable findings were noted for similar actigraphic improvement criteria. The SH therapy patients showed favorable outcomes on measures of pain and mental well-being. This finding was most notable in an SH therapy subgroup that self-elected to implement selected CBT strategies. CONCLUSIONS: Cognitive-behavioral therapy represents a promising intervention for sleep disturbance in FM patients. Larger clinical trials of this intervention with FM patients seem warranted.

Full Text

Duke Authors

Cited Authors

  • Edinger, JD; Wohlgemuth, WK; Krystal, AD; Rice, JR

Published Date

  • November 2005

Published In

Volume / Issue

  • 165 / 21

Start / End Page

  • 2527 - 2535

PubMed ID

  • 16314551

Pubmed Central ID

  • 16314551

Electronic International Standard Serial Number (EISSN)

  • 1538-3679

International Standard Serial Number (ISSN)

  • 0003-9926

Digital Object Identifier (DOI)

  • 10.1001/archinte.165.21.2527

Language

  • eng