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Cognitive Therapy and Research

, Volume 42, Issue 1, pp 63–79 | Cite as

Efficacy of Combined Cognitive-Behavioral Therapy for Insomnia and Pain in Patients with Fibromyalgia: A Randomized Controlled Trial

  • María J. Lami
  • M. Pilar Martínez
  • Elena Miró
  • Ana I. Sánchez
  • Germán Prados
  • Rafael Cáliz
  • Johan W. S. Vlaeyen
Original Article
  • 607 Downloads

Abstract

This controlled trial aims to analyze the efficacy of cognitive-behavioral therapy for insomnia and pain (CBT-IP) compared to cognitive-behavioral therapy for pain (CBT-P) and usual medical care (UMC) at improving sleep and other clinical manifestations (pain, fatigue, impaired functioning, and emotional distress) in women with fibromyalgia (FM). One hundred and twenty-six patients with FM were randomly assigned to different treatment groups and 113 completed the treatments (38 in the CBT-IP group, 34 in the CBT-P group and 41 in the UMC group) and a number of self-reports at pre-treatment, post-treatment, and 3 months of follow-up. The CBT-IP group showed significant improvements at post-treatment in several sleep variables (i.e., subjective sleep quality, sleep latency, sleep efficiency, and use of sleeping medication) that were not observed in the CBT-P and UMC groups. The CBT-IP and CBT-P groups reported significant improvements at post-treatment in FM impact and self-efficacy for coping with pain; the CBT-IP group reported improvements at follow-up in pain intensity, and the CBT-P reported improvements at post-treatment in pain catastrophizing and pain acceptance. Clinical improvements are also described. The findings revealed differential responses between groups regarding sleep and other adjustment parameters and the CBT-IP group exhibited the best clinical response pattern overall. More research in the area of FM treatment is needed to enhance the efficacy of the CBT and identify which patients are likely to benefit from each modality of CBT.

Keywords

Fibromyalgia Cognitive-behavioral therapy Insomnia Randomized controlled trial 

Notes

Funding

This research was financially supported by the Spanish Ministry of Science and Innovation (ref. PSI2009-13765PSIC) and Spanish Ministry of Economy and Competitiveness (ref. PSI2014-58379-P).

Compliance with Ethical Standards

Conflict of Interest

María J. Lami, M. Pilar Martínez, Elena Miró, Ana I. Sánchez, Germán Prados, Rafael Cáliz and Johan W. S. Vlaeyen declares that they have no conflict of interest.

Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Granada Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Animal Rights Statement

No animal studies were carried out by the authors for this article.

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© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Personality, Assessment and Psychological TreatmentUniversity of GranadaGranadaSpain
  2. 2.Mind, Brain and Behavior Research CenterUniversity of GranadaGranadaSpain
  3. 3.Department of NursingUniversity of GranadaGranadaSpain
  4. 4.Rheumatology ServiceVirgen de las Nieves University HospitalGranadaSpain
  5. 5.Faculty of Psychology and Educational Sciences, Research Group Health PsychologyUniversity of LeuvenLeuvenBelgium
  6. 6.Faculty of Psychology and Neuroscience, Research Group Behavioral MedicineMaastricht UniversityMaastrichtNetherlands
  7. 7.Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de PsicologíaUniversidad de GranadaGranadaSpain

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