New study show that older patiant that suffer from arthiritis and sleep distarbance are likely relieve panin By Cognitive Therapy.

Insomnia

Osteoarthritis patients initially reported sleeping 21 minutes longer per night on average after receiving cognitive behavior therapy for insomnia and 27 minutes longer a year after treatment .

Patients who received cognitive behavior therapy for insomnia (CBT-I) also experienced a significant reduction in arthritis pain compared to those in a control group,

“These results further suggest that techniques to improve sleep, such as CBT-I, should be considered as additions to the various existing behavioral treatment programs for pain management in osteoarthritis, and possibly in other chronic pain conditions as well,” the authors wrote.

The number of U.S. osteoarthritis patients is growing rapidly as the population ages. The disease is often accompanied by difficulty sleeping, and 60% of people with osteoarthritis report feeling pain during the night.

Vitiello and colleagues tested whether cognitive behavioral therapy could help these patients sleep better and, given the established link between sleep problems and pain, determine whether improved sleep might also reduce arthritis pain.

Between 2001 and 2003, the researchers studied six men and 45 women who were age 55 or older and had osteoarthritis and difficulty sleeping. The patients were randomized to receive either CBT-I or a combination of stress management and wellness counseling (the control) at Rush University Medical Center in Chicago.

The CBT-I counseling consisted of eight weekly, two-hour group classes of four to eight participants. Each was led by an experienced clinical psychologist. Patients were placed on a strict schedule of bedtimes and waking times, beginning with the amount of time they were they were actually sleeping (but a minimum of 4.5 hours).

They were told to lie in bed awake no longer than 15 minutes and to engage inno activities in bed other than sleep and sex. If they began to spend more of their time in bed asleep, their hours of sleep were increased by a maximum of one-half hour each week.

Cognitive restructuring techniques helped participants change unrealistic beliefs and irrational fears regarding sleep or lack of it. They also received relaxation training and instruction about other factors that might affect their sleep, such as getting enough sunlight and exercise and avoiding alcohol and caffeine.

The participant’s sleep patterns were tracked with handwritten sleep logs, while their pain levels were recorded by the Short-Form McGill Pain Questionnaire (MPQ) and the Body Pain Subscale (SF-PAIN) question from the Medical Outcomes Study Short Form-36 Pain.

Patients who received CBT-I reported falling asleep an average of 17 minutes faster initially and 11 minutes faster a year after treatment ). Once, asleep they remained asleep an average of 37 minutes longer initially and 20 minutes longer after a year .

They also generally spent more of their bed time sleeping, reporting a 13% initial increase in sleep efficiency and an 8% increase after a year

In addition to the sleep benefits, patients who underwent CBT-I had average improvement of 9.7 points initially and 4.7 points a year after treatment on the SF-Pain question.

“These results, while preliminary, support the hypothesis that improving sleep, per se, in patients with osteoarthritis may be analgesic, such that perceived pain is reduced without being specifically targeted,” the authors wrote.

“These results further suggest that techniques to improve sleep, such as CBT-I, should be considered as additions to the various existing behavioral treatment programs for pain management in osteoarthritis, and possibly in other chronic pain conditions as well.”

Acknowledging that larger studies are needed to confirm their findings, the researchers also noted that the attention-control stress management and wellness intervention was not an ideal control because some of its techniques are similar to those used in CBT-I.

They also urged caution in generalizing the study findings to men, since most of the participants were women.