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Sleeping with pain: Development and evaluation of a programme for people with insomnia secondary to chronic pain

Sue Peacock

 Introduction: Traditionally, treatment for secondary insomnia has focussed on the condition assumed to initiate sleep disturbance rather than insomnia (Ashworth, Davidson & Espie, 2010), such as providing one session in a pain management programme focussing on sleep. Research suggests those experiencing insomnia as a result of chronic pain have higher levels of dysfunctional beliefs about their sleep than those without chronic pain (Ashworth, Davidson & Espie, 2010; Afolalu et al, 2016). Research suggests that Cognitive Behaviour Therapy interventions are effective in improving the quality and quantity of sleep; however, they remain underused (Currie et al, 2000). Method: An intervention combining CBT and mindfulness was developed for chronic pain patients reporting sleep disturbance. The programme aimed to improve understanding of the biopsychosocial model of pain; to provide patients with a way of assessing their sleep problem; 

 

Relaxation skills; to reshape sleep so it meets their own needs and develops a strong pattern; to teach ways of overcoming mental alertness, repetitive thoughts and anxieties that interfere with sleep; to use all this information to develop their own action plan. Quantitative and qualitative feedback was obtained. Results: Quantitative results show all 40 patients improved aspects of their sleep. Qualitative themes emerged were group support, information, change in thoughts/behaviours, the challenge of implementing new sleep patterns. Conclusions: Provided evidence that this programme is beneficial. Should the programme become more widely available, it could act as an effective and empowering treatment that relieves some dependence on pharmaceuticals as well as the debilitating effects of chronic pain. To make this programme more accessible, a book sleeping with Pain has been written and an online programme is in development.