Frontiers in Psychology (Jan 2024)

Telehealth delivery of adapted CBT-I for insomnia in chronic pain patients: a single arm feasibility study

  • Zoe Zambelli,
  • Elizabeth J. Halstead,
  • Antonio R. Fidalgo,
  • Stephen Mangar,
  • Dagmara Dimitriou

DOI
https://doi.org/10.3389/fpsyg.2023.1266368
Journal volume & issue
Vol. 14

Abstract

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ObjectivesA large proportion of individuals with chronic pain experience insomnia-related symptoms which can be persistent in nature, and negatively impact one’s quality of life. This single arm trial aimed to investigate the feasibility and preliminary efficacy of CBT-I, adapted for people with chronic musculoskeletal pain, delivered via telehealth.MethodsWe conducted a single arm feasibility trial in which 10 adult women (M age = 50.76 years, SD = 8.03 years) with self-reported insomnia and a diagnosed chronic musculoskeletal chronic pain received six CBT-I individual treatment sessions over 6–10 weeks. Treatment was delivered via telehealth. Participants completed weekly sleep diaries, and self-reported measures of insomnia, pain, anxiety and depression pre-treatment, post-treatment, and one-month follow-up.ResultsThe trial yielded, high levels of compliance with intervention protocols, and affirmative feedback on satisfaction which demonstrated feasibility. The enrolment rate into the study was 37% (27 participants screened, 10 participants enrolled). The intervention was associated with statistically and clinically meaningful improvements in self-reported insomnia severity. There were statistically significant improvements in sleep efficiency, wake after sleep onset, sleep onset latency, anxiety and depression.ConclusionAdapted CBT-I delivered via telehealth may be a feasible, acceptable, and efficacious therapeutic approach for individuals with co-existent sleep and chronic pain. Future trials should adopt a randomized design against usual care.

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