A new study finds that pain generally doesn’t affect how cognitive behavioral therapy for insomnia (CBT-I) works in older adults, so they shouldn’t avoid using the treatment. CBT-I is the gold-standard treatment for insomnia disorder in adults.
The study assessed pain and sleep outcomes on supervised CBT-I among 106 community-dwelling older adults. Of them, most were male and the mean age was 72. The findings were published Tuesday in the Journal of the American Geriatrics Society.
Participants completed five sessions of manual-based CBT-I in individual or group format in a Department of Veterans Affairs healthcare system. Sleep coaches, not clinicians, led the weekly phone sessions. The team collected data when the study started, a week after the last session ended, at six months after treatment, and at 12 months after treatment.
People in the study who had the worst sleep symptoms at the start of the trial had pain that was higher and more unstable than their peers. Having higher levels of pain compared to the group average was also linked with higher baseline insomnia and fatigue, as well as poorer baseline sleep quality.
According to the data, CBT-I improved insomnia symptoms, perceived sleep quality, fatigue and daytime sleepiness among older veterans with chronic insomnia. In other words, experiencing chronic pain won’t affect the outcomes of CBT-I, the researchers said.
Pain didn’t affect improvements in other sleep-related outcomes, the data showed.
“Co-occurring pain does not interfere with the effectiveness of CBT-I in older adult patients,” the authors wrote.
“Overall, results support the use of CBT-I for older individuals experiencing pain of varying severities and stability, with individuals who are in moderate to high pain appearing to benefit slightly more in regard to insomnia symptom improvement; a presentation of pain commonly seen in older veterans,” the team added.
