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Cognitive behavioural therapy improved most sleep outcomes in insomnia secondary to chronic pain

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QUESTION: In patients with insomnia secondary to chronic pain, does cognitive behavioural therapy (CBT) improve sleep outcomes?


Randomised {allocation concealed*}, unblinded*, controlled trial with 3 months of follow up.


3 clinics in Canada.


60 patients who were <60 years of age (mean age 45 y, 55% women), had non-malignant chronic pain of a musculoskeletal origin but not fibromyalgia (mean duration 9.2 y), reported sleep difficulties (mean duration of insomnia 7.9 y), and had no major medical or psychiatric disorder. Primary pain sites were back (72%), neck (20%), lower limbs (5%), or pelvic region (3%). 67% of patients used medication regularly. Follow up was 85%.


Patients were allocated …

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