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Insomnia and Pain in Patients With Knee OA

Can behavior modification provide relief?

Publish date:: June 8, 2015

Cognitive-behavioral therapy in insomnia (CBT-I) was effective in reducing sleep maintenance insomnia and reducing clinical pain, according to a randomized, double-blind, active placebo-controlled study of 100 patients with knee osteoarthritis and insomnia. Researchers found:

• Patients in both the CBT-I group and the active placebo group showed substantial improvement in sleep and significant and comparable reductions in pain over 6 months, with one-third of all patients reporting a 30% reduction in pain severity.

• Patients in the CBT-I group had significantly greater reduction in wake after sleep onset (WASO).

• Baseline-to-posttreatment reductions in WASO predicted reductions in clinical pain, an effect significantly greater in the CBT-I group.

• No significant changes in laboratory measures of pain modulation were seen.

Citation: Smith MT, Finan PH, Buenaver LF, et al. Cognitive–behavioral therapy for insomnia in knee osteoarthritis: a randomized, double-blind, active placebo–controlled clinical trial. Arthritis Rheumatol. 2015 May;67(5):1221-33. doi: 10.1002/art.39048.

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