Chronic Pain Clinical Trial
Official title:
Cognitive Behavioral Therapy for Insomnia in Chronic Pain Patients
This study of cognitive behavioral therapy for insomnia in chronic pain patients is a randomized, controlled clinical trial of parallel groups with three and six months follow up.
Forty five subjects, both male and female, of diverse racial backgrounds, ages >25 with
insomnia secondary to pain will be recruited from the Pain Clinic at URMC and from the
community at large via advertisements and solicited primary care referrals to participate in
a parallel-groups, randomized, single blind, controlled trial. Protocol eligible subjects
(as determined via a phone screen interview or by responses to our web based screening
questionnaire) will be evaluated in-lab. The screen will determine whether subjects have
chronic insomnia secondary to pain and do not meet any of the exclusion criteria. Once found
to be study eligible, they are given an appointment for the reading and signing of the
consent and the intake interview. The in-lab intake interview includes the administration of
a broad battery of self-report instruments. Following the clinical interview, subjects will
undergo a physical exam. The history (to include drug and ETOH use) and physical examination
will include blood and urine chemistries to rule out any acute or unstable medical
co-morbidity (including pregnancy). The lab work will include profiles to assess renal,
liver, thyroid, and anemia as well as urine toxicology screen for illicit drug use. The lab
work results will be reviewed by the Co-PI and our medical consultant. If significant
abnormal findings are discovered, the subject will be referred to their primary care
provider for treatment. In addition to conducting an "in-house" physical, after the subject
signs a release of information, the researchers also FAX the prospective subject's primary
care physician a letter asking them to confirm that the individual is eligible for the
study.
If data from both these evaluations suggest that the subject is protocol eligible, according
to the inclusion and exclusion criteria, the subject is asked to fill out two weeks of
sleep/pain diaries. The diary data are used to "prospectively" confirm the severity and
frequency of the subjects sleep complaints and as baseline data. Finally, all subjects will
be evaluated by polysomnography (PSG) to assure that they do not have an occult sleep
disorder. Once determined to be study appropriate, the subjects will be randomized into a
treatment group. They will see the therapist weekly for 8 weeks. At 3 month and 6 month
intervals after weekly therapy session end, the subject will be asked to fill out sleep
diaries and wear an actiwatch for a period of two weeks.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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