Does Chronic Pain Affect the Efficacy of Cognitive-Behavioral Therapy for Insomnia?

Cognitive-behavioral therapy for insomnia (CBT-I) is considered to be first-line treatment for most patients with chronic insomnia, but its efficacy in patients who are experiencing pain has not been studied extensively. To address this question, researchers performed a secondary analysis of data from a prior randomized trial in which five sessions of CBT-I was compared with general sleep education in older U.S. veterans (mean age, 72; 96% men) with chronic insomnia (J Am Geriatr Soc 2013; 61:947). CBT-I was administered by nonclinician sleep coaches who were supervised by behavioral sleep specialists.

Among 106 patients who were randomized to receive CBT-I, more than half reported chronic pain at baseline; higher pain scores were associated…