Insomnia remission and improvement of bodily pain in older adults: a randomized clinical trial
Abstract. Introduction:. Older adults with insomnia frequently report bothersome pain. Whether insomnia treatment reduces bodily pain in older adults without chronic pain conditions is not known. Objectives:. This randomized controlled trial aimed to determine whether treatment of insomnia disorder...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-04-01
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| Series: | PAIN Reports |
| Online Access: | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001243 |
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| author | Martin F. Bjurstrom Richard Olmstead Michael R. Irwin |
| author_facet | Martin F. Bjurstrom Richard Olmstead Michael R. Irwin |
| author_sort | Martin F. Bjurstrom |
| collection | DOAJ |
| description | Abstract. Introduction:. Older adults with insomnia frequently report bothersome pain. Whether insomnia treatment reduces bodily pain in older adults without chronic pain conditions is not known.
Objectives:. This randomized controlled trial aimed to determine whether treatment of insomnia disorder with cognitive behavioral therapy for insomnia (CBT-I), as compared with sleep education therapy (SET), yields durable remission of insomnia and reduces moderate pain symptoms over 36 months in older adults with insomnia disorder.
Methods:. A community-based sample of 291 adults ages 60 years and older (mean age, 70.1 years; 57.7% female) with insomnia disorder, but no chronic pain condition, were randomized to 2 months of intervention with either CBT-I (n = 156) or SET (n = 135). The primary outcome was change in bodily pain as measured by the short form 36 (SF-36) health survey. Secondary outcome was remission of insomnia continuously sustained over 36 months of follow-up.
Results:. Improvements in bodily pain, as indexed by increases in SF-36 scores, were found in CBT-I with insomnia remission (adjusted β = 0.18; 95% CI, 0.004–0.360; P = 0.045) and in SET with insomnia remission (adjusted β = 0.25; 95% CI, 0.035–0.457; P = 0.023) but not in treatment groups without insomnia remission. As compared with those without insomnia remission, insomnia remission was associated with improvements in pain (adjusted β = 0.19; 95% CI, 0.047–0.325; P = 0.009) and with increases in the proportion of participants who achieved a minimal clinically important difference (likelihood ratio χ21,16 = 264.04; P < 0.001).
Conclusions:. Sustained remission of insomnia disorder leads to improvements in bodily pain, with the potential to prevent chronic pain disorders in older adults with insomnia.
Trial Registration:. ClinicalTrials.gov NCT01641263. |
| format | Article |
| id | doaj-art-dc46bcd1b24944cc82d75721aa71f154 |
| institution | OA Journals |
| issn | 2471-2531 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | PAIN Reports |
| spelling | doaj-art-dc46bcd1b24944cc82d75721aa71f1542025-08-20T02:03:36ZengWolters KluwerPAIN Reports2471-25312025-04-01102e124310.1097/PR9.0000000000001243PR90000000000001243Insomnia remission and improvement of bodily pain in older adults: a randomized clinical trialMartin F. Bjurstrom0Richard Olmstead1Michael R. Irwin2a Department of Surgical Sciences, Uppsala University, Uppsala, Swedenb Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USAb Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USAAbstract. Introduction:. Older adults with insomnia frequently report bothersome pain. Whether insomnia treatment reduces bodily pain in older adults without chronic pain conditions is not known. Objectives:. This randomized controlled trial aimed to determine whether treatment of insomnia disorder with cognitive behavioral therapy for insomnia (CBT-I), as compared with sleep education therapy (SET), yields durable remission of insomnia and reduces moderate pain symptoms over 36 months in older adults with insomnia disorder. Methods:. A community-based sample of 291 adults ages 60 years and older (mean age, 70.1 years; 57.7% female) with insomnia disorder, but no chronic pain condition, were randomized to 2 months of intervention with either CBT-I (n = 156) or SET (n = 135). The primary outcome was change in bodily pain as measured by the short form 36 (SF-36) health survey. Secondary outcome was remission of insomnia continuously sustained over 36 months of follow-up. Results:. Improvements in bodily pain, as indexed by increases in SF-36 scores, were found in CBT-I with insomnia remission (adjusted β = 0.18; 95% CI, 0.004–0.360; P = 0.045) and in SET with insomnia remission (adjusted β = 0.25; 95% CI, 0.035–0.457; P = 0.023) but not in treatment groups without insomnia remission. As compared with those without insomnia remission, insomnia remission was associated with improvements in pain (adjusted β = 0.19; 95% CI, 0.047–0.325; P = 0.009) and with increases in the proportion of participants who achieved a minimal clinically important difference (likelihood ratio χ21,16 = 264.04; P < 0.001). Conclusions:. Sustained remission of insomnia disorder leads to improvements in bodily pain, with the potential to prevent chronic pain disorders in older adults with insomnia. Trial Registration:. ClinicalTrials.gov NCT01641263.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001243 |
| spellingShingle | Martin F. Bjurstrom Richard Olmstead Michael R. Irwin Insomnia remission and improvement of bodily pain in older adults: a randomized clinical trial PAIN Reports |
| title | Insomnia remission and improvement of bodily pain in older adults: a randomized clinical trial |
| title_full | Insomnia remission and improvement of bodily pain in older adults: a randomized clinical trial |
| title_fullStr | Insomnia remission and improvement of bodily pain in older adults: a randomized clinical trial |
| title_full_unstemmed | Insomnia remission and improvement of bodily pain in older adults: a randomized clinical trial |
| title_short | Insomnia remission and improvement of bodily pain in older adults: a randomized clinical trial |
| title_sort | insomnia remission and improvement of bodily pain in older adults a randomized clinical trial |
| url | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001243 |
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