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. LamiEmail author
  • M. Pilar Martínez
  • Elena Miró
  • Ana I. Sánchez
  • Germán Prados
  • Rafael Cáliz
  • Johan W. S. Vlaeyen
Original Article


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.


Fibromyalgia Cognitive-behavioral therapy Insomnia Randomized controlled trial 



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.


  1. Alegre de Miquel, C., Campayo, J.G., Flórez, M.T., Arguelles, J. M. G., Tarrio, B.E., & Montoya, M.G. (2010). Documento de consenso interdisciplinar para el tratamiento de la fibromialgia [Interdisciplinary consensus document for the treatment of fibromyalgia]. Actas Españolas de Psiquiatría, 38, 108–120.Google Scholar
  2. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th. ed. rev.). Washington, DC: American Psychiatric Association.Google Scholar
  3. Anderson, K. O., Dowds, B. N., Pelletz, R. E., Edwards, W. T., & Peeters-Asdourian, C. (1995). Development and initial validation of a scale to measure self-efficacy beliefs in patients with chronic pain. Pain, 63, 77–84. doi: 10.1016/0304-3959(95)00021-J CrossRefPubMedGoogle Scholar
  4. Belt, N. K., Kronholm, E., & Kauppi, M. J. (2009). Sleep problems in fibromyalgia and rheumatoid arthritis compared with the general population. Clinical and Experimental Rheumatology, 27, 35–41.PubMedGoogle Scholar
  5. Bernardy, K., Fueber, N., Koellner, V., & Häuser, W. (2010). Efficacy of cognitive-behavioral therapies in fibromyalgia syndrome: A systematic review and meta-analysis of randomized controlled trials. The Journal of Rheumatology, 37, 1991–2005. doi: 10.3899/jrheum.100104 CrossRefPubMedGoogle Scholar
  6. Branco, J. C., Bannwarth, B., Failde, I., Abello Carbonell, J., Blotman, F., Spaeth, M., & …Matucci-Cerinic, M. (2010). Prevalence of fibromyalgia: A survey in five European countries. Seminars in Arthritis and Rheumatism, 39, 448–453. doi: 10.1016/j.semarthrit.2008.12.003 CrossRefPubMedGoogle Scholar
  7. Bryson, J., Read, J. B., Bush, J., & Edwards, C. L. (2014). A Clinical intervention in chronic pain and insomnia with a combined model of treatment: A test of concept. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 32, 279–296. doi: 10.1007/s10942-014-0194-3 CrossRefGoogle Scholar
  8. Burckhardt, C., Clark, S., & Bennet, R. (1991). The fibromyalgia Impact questionnaire: development and validation. The Journal of Rheumatology, 18, 728–734.PubMedGoogle Scholar
  9. Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.CrossRefPubMedGoogle Scholar
  10. Canivet, C., Ostergren, P. O., Choi, B., Nilsson, P., af Sillén, U., Moghadassi, M., . . . & Isacsson, S. O. (2008). Sleeping problems as a risk factor for subsequent musculoskeletal pain and the role of job strain: Results from a one year follow-up of the Malmo Shoulder Neck Study Cohort. International Journal of Behavioral Medicine, 15, 254–262. doi: 10.1080/10705500802365466.CrossRefPubMedGoogle Scholar
  11. Clauw, D. J. (2014). Fibromyalgia: A clinical review. JAMA: The Journal of the American Medical Association, 311, 1547–1555. doi: 10.1001/jama.2014.3266.CrossRefPubMedGoogle Scholar
  12. Cohen, J. (1988). Statistical power analysis for the behavior sciences (2nd edn.). Hillsdale: Lawrence Erlbaum.Google Scholar
  13. Cole, J. C., Dubois, D., & Kosinski, M. (2007). Use of patient-reported sleep measures in clinical trials of pain treatment: A literature review and synthesis of current sleep measures and a conceptual model of sleep disturbance in pain. Clinical Therapeutics, 29, 2580–2588. doi: 10.1016/j.clinthera.2007.12.005.CrossRefPubMedGoogle Scholar
  14. Currie, S. R., Wilson, K. G., Pontefract, A. J., & deLaplante, L. (2000). Cognitive-behavioral treatment of insomnia secondary to chronic pain. Journal of Consulting and Clinical Psychology, 68, 407–416. doi: 10.1037/0022-006X.68.3.407 CrossRefPubMedGoogle Scholar
  15. Derogatis, L. R. (2002). SCL-90-R. Cuestionario de 90 síntomas. [SCL-90-R. Symptom checklist 90 revised]. Madrid: TEA Ediciones.Google Scholar
  16. Díaz-Piedra, C., Di Stasi, L. L., Baldwin, C. M., Buela-Casal, G., & Catena, A. (2015). Sleep disturbances of adult women suffering from fibromyalgia: A systematic review of observational studies. Sleep Medicine Reviews, 21, 86–99. doi: 10.1016/j.smrv.2014.09.001 CrossRefPubMedGoogle Scholar
  17. Edinger, J. D., Wohlgemuth, W. K., Krystal, A. D., & Rice, J. R. (2005). Behavioral insomnia therapy for fibromyalgia patients: A randomized clinical trial. Archives of Internal Medicine, 165, 2527–2535. doi: 10.1001/archinte.165.21.2527.CrossRefPubMedGoogle Scholar
  18. Fillion, L., Gélinas, C., Simard, S., Savard, J., & Gagnon, P. (2003). Validation evidence for the French Canadian adaptation of the multidimensional fatigue inventory as a measure of cancer-related fatigue. Cancer Nursing, 26, 143–154.CrossRefPubMedGoogle Scholar
  19. Finan, P. H., Buenaver, L., Coryell, V. T., & Smith, M. (2014). Cognitive-behavioral therapy for comorbid insomnia and chronic pain. Sleep Medicine Clinics, 9, 261–274. doi: 10.1016/j.jsmc.2014.02.007 CrossRefPubMedPubMedCentralGoogle Scholar
  20. Fitzcharles, M., & Yunus, M. (2012). The clinical concept of fibromyalgia as a changing paradigm in the past 20 years. Pain Research and Treatment. doi: 10.1155/2012/184835 PubMedCentralGoogle Scholar
  21. García-Campayo, J., Rodero, R., Alda, M., Sobradiel, N., Montero, J., & Moreno, S. (2008). Validación de la versión española de la Escala de la Catastrofización ante el Dolor (Pain Catastrophizing Scale) en la fibromialgia [Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia]. Medicina Clínica, 131, 487–492. doi: 10.1157/13127277.CrossRefPubMedGoogle Scholar
  22. Glombiewski, J. A., Sawyer, A. T., Gutermann, J., Koenig, K., Rief, W., & Hofmann, S. G. (2010). Psychological treatments for fibromyalgia: A meta-analysis. Pain, 151, 280–295. doi:  10.1016/j.pain.2010.06.011 CrossRefPubMedGoogle Scholar
  23. Hamilton, N. A., Catley, D., & Karlson, C. (2007). Sleep and the affective response to stress and pain. Health Psychology, 26, 288–295. doi:  10.1037/0278-6133.26.3.288 CrossRefPubMedGoogle Scholar
  24. Harvey, A. (2005). A cognitive theory and therapy for chronic insomnia. Journal of Cognitive Psychotherapy: An International Quarterly, 19, 41–59. doi: 10.1891/jcop. CrossRefGoogle Scholar
  25. Häuser, W., Thieme, K., & Turk, D. C. (2010). Guidelines on the management of fibromyalgia syndrome: A systematic review. European Journal of Pain, 14, 5–10. doi: 10.1016/j.ejpain.2009.01.006 CrossRefPubMedGoogle Scholar
  26. Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19. doi: 10.1037//0022-006X.59.1.12 CrossRefPubMedGoogle Scholar
  27. Jungquist, C. R., O’Brien, C., Matteson-Rusby, S., Smith, M. T., Pigeon, W. R., Xia, Y., & Perlis, M. L. (2010). The efficacy of cognitive behavioral therapy for insomnia in patients with chronic pain. Sleep Medicine, 11, 302–309. doi: 10.1016/j.sleep.2009.05.018.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Kim, Y. (2011). Missing data handling in chronic pain trials. Journal of Biopharmaceutical Statistics, 21, 311–325. doi:  10.1080/10543406.2011.550112 CrossRefPubMedGoogle Scholar
  29. Lázaro, C., Caseras, X., Whizar-Lugo, V. M., Wenk, R., Baldioceda, F., Bernal, R.,. . .& Baños, J. E. (2001). Psychometric properties of a Spanish version of the McGill pain questionnaire in several Spanish-speaking countries. The Clinical Journal of Pain, 17, 365–374.CrossRefPubMedGoogle Scholar
  30. Lee, Y. C., Nassikas, N. J., & Clauw, D. J. (2011). The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgia. Arthritis Research and Therapy, 13, 211. doi: 10.1186/ar3306 CrossRefPubMedPubMedCentralGoogle Scholar
  31. Leeuw, M., Goossens, M., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. S. (2007). The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. Journal of Behavioral Medicine, 30, 77–94. doi: 10.1007/s10865-006-9085-0 CrossRefPubMedGoogle Scholar
  32. Martín-Aragón, M., Pastor, M. A., Rodríguez-Marín, J., March, M. J., Lledó, A., López-Roig, S., & Terol, M. C. (1999). Percepción de autoeficacia en dolor crónico: Adaptación y validación de la chronic pain self-efficacy scale [Perceived self-efficacy in chronic pain: Adaptation and validation of the chronic pain self-efficacy scale]. Revista de Psicología de la Salud, 11, 53–75.Google Scholar
  33. Martínez, M. P., Miró, E., & Sánchez, A. I. (2014b). Tratamiento psicológico del insomnio en la fibromialgia y otros síndromes de dolor crónico [Psychological treatment of insomnia in fibromyalgia and other chronic pain syndromes]. CM de Psicobioquímica, 3, 39–54.Google Scholar
  34. Martínez, M. P., Miró, E., Sánchez, A. I., Díaz-Piedra, C., Cáliz, R., Vlaeyen, J. W. S., & Buela-Casal, G. (2014a). Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: A randomized controlled trial. Journal of Behavioral Medicine, 37, 683–697. doi:  10.1007/s10865-013-9520-y CrossRefPubMedGoogle Scholar
  35. Martínez, M. P., Sánchez, A. I., Miró, E., Lami, M. J., Prados, G., & Morales, A. (2015). Relationships between physical symptoms, emotional distress, and pain appraisal in fibromyalgia: The moderator effect of alexithymia. The Journal of Psychology: Interdisciplinary and Applied, 149, 115–140. doi: 10.1080/00223980.2013.844673 CrossRefGoogle Scholar
  36. McCracken, L. M., Vowles, K. E., & Eccleston, C. (2004). Acceptance of chronic pain: Component analysis and revised assessment method. Pain, 107, 159–166.CrossRefPubMedGoogle Scholar
  37. McCurry, S. M., Shortreed, S. M., Von Korff, M., Balderson, B. H., Baker, L. D., Rybarczyk, B. D., & Vitiello, M. V. (2014). Who benefits from CBT for insomnia in primary care? Important patient selection and trial design lessons from longitudinal results of the lifestyles trial. Sleep, 37, 299–308. doi:  10.5665/sleep.3402 CrossRefPubMedPubMedCentralGoogle Scholar
  38. Melzack, R. (1987). The short form McGill pain questionnaire. Pain, 30, 191–197.CrossRefPubMedGoogle Scholar
  39. Miró, E., Lupiáñez, J., Hita, E., Martínez, M. P., Sánchez, A. I., & Buela-Casal, G. (2011a). Attentional deficits in fibromyalgia and its relationships with pain, emotional distress and sleep dysfunction complaints. Psychology and Health, 26, 765–780. doi:  10.1080/08870446.2010.493611 CrossRefPubMedGoogle Scholar
  40. Miró, E., Lupiáñez, J., Martínez, M. P., Sánchez, A. I., Díaz-Piedra, C., Guzmán, M. A., & Buela-Casal, G. (2011b). Cognitive-behavioral therapy for insomnia improves attentional function in fibromyalgia syndrome: A pilot, randomized controlled trial. Journal of Health Psychology, 16, 770–782. doi:  10.1177/1359105310390544 CrossRefPubMedGoogle Scholar
  41. Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J.,. . .& Altman, D. G. (2010). CONSORT 2010. Explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. British Medical Journal, 340, c869. doi: 10.1136/bmj.c869.CrossRefPubMedPubMedCentralGoogle Scholar
  42. Moldofsky, H. (2009). The significance of dysfunctions of the sleeping/waking brain to the pathogenesis and treatment of fibromyalgia syndrome. Rheumatic Diseases Clinics of North America, 35, 275–283. doi: 10.1016/j.rdc.2009.05.008 CrossRefPubMedGoogle Scholar
  43. Moldofsky, H. (2010). Rheumatic manifestations of sleep disorders. Current Opinion in Rheumatology, 22, 59–63. doi: 10.1097/BOR.0b013e328333b9cc CrossRefPubMedGoogle Scholar
  44. Morgenthaler, T., Kramer, M., Alessi, C., Friedman, L., Boehlecke, B., Brown, T.,. .. & Swick, T. (2006). Practice parameters for the psychological and behavioral treatment of insomnia: An update. An American Academy of Sleep Medicine report. Sleep, 29, 1415–1419.CrossRefPubMedGoogle Scholar
  45. Morin, C. M. (1998). Insomnio. Asistencia y tratamiento psicológico [Insomnia. Assistance and psychological treatment]. Barcelona: Ariel.Google Scholar
  46. Osorio, C. D., Gallinaro, A. L., Lorenzi-Filho, G., & Lage, L. V. (2006). Sleep quality in patients with fibromyalgia using the Pittsburgh sleep quality index. The Journal of Rheumatology, 33, 1863–1865.PubMedGoogle Scholar
  47. Palagini, L., Carmassi, C., Conversano, C., Gesi, C., Bazzichi, L., Giacomelli, C., & Dell’Osso, L. (2016). Transdiagnostic factors across fibromyalgia and mental disorders: Sleep disturbances may play a key role. A clinical review. Clinical and Experimental Rheumatology, 34, 140–144.Google Scholar
  48. Pigeon, W. R., Moynihan, J., Matteson-Rusby, S., Jungquist, C. R., Xia, Y., Tu, X., & Perlis, M. L. (2012). Comparative effectiveness of CBT interventions for co-morbid chronic pain & insomnia: A pilot study. Behaviour Research and Therapy, 50, 685–689. doi: 10.1016/j.brat.2012.07.005 CrossRefPubMedPubMedCentralGoogle Scholar
  49. Prados, G., & Miró, E. (2012). Fibromialgia y sueño: Una revisión [Fibromyalgia and sleep: A review]. Revista de Neurología, 54, 227–240.PubMedGoogle Scholar
  50. Prados, G., Miró, E., Martínez, M. P., Sánchez, A. I., Lami, M. J., & Cáliz, R. (in review). Effects of combined cognitive-behavioral therapy on polysomnographic parameters and perceived sleep quality in fibromyalgia women.Google Scholar
  51. Rivera, J., & González, T. (2004). The fibromyalgia impact questionnaire: A validated Spanish version to assess the health status in women with fibromyalgia. Clinical and Experimental Rheumatology, 22, 554–560.PubMedGoogle Scholar
  52. Rodero, B., García-Campayo, J., Casanueva, B., López del Hoyo, Y., Serrano-Blanco, A., & Luciano, J. V. (2010). Validation of the Spanish version of the chronic pain acceptance questionnaire (CPAQ) for the assessment of acceptance in fibromyalgia. Health and Quality of Life Outcomes, 8, 37. doi: 10.1186/1477-7525-8-37 CrossRefPubMedPubMedCentralGoogle Scholar
  53. Royuela, A., & Macías, J. A. (1997). Propiedades clinimétricas de la versión castellana del cuestionario de Pittsburgh [Clinimetrical properties of the Spanish version of the Pittsburgh questionnaire]. Vigilia-Sueño, 9, 81–94.Google Scholar
  54. Rybarczyk, B., Stepanski, E., Fogg, L., López, M., Barry, P., & Davis, A. A. (2005). A placebo-controlled test of cognitive-behavioral therapy for comorbid insomnia in older adults. Journal of Consulting and Clinical Psychology, 73, 1164–1174. doi:  10.1037/0022-006X.73.6.1164 CrossRefPubMedGoogle Scholar
  55. Salaberría, K., Páez, D., & Echeburúa, E. (1996). Evaluación de la validez del cambio inducido por los tratamientos psicológicos [Assessment of the validity of change induced by psychological treatments]. Boletín de Psicología, 52, 71–96.Google Scholar
  56. Sánchez, A. I., Díaz-Piedra, C., Miró, E., Martínez, M. P., Gálvez, R., & Buela-Casal, G. (2012). Effects of cognitive-behavioral therapy for insomnia on polysomnographic parameters in fibromyalgia patients. International Journal of Clinical and Health Psychology, 12, 39–53.Google Scholar
  57. Sedgwick, P. (2014). Explanatory trials versus pragmatic trials. BMJ, 14, 349–351. doi:  10.1136/bmj.g6694 Google Scholar
  58. Smeets, R. J., Vlaeyen, J. W., Kester, A. D., & Knottnerus, J. A. (2006). Reduction of pain catastrophizing mediates the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. The Journal of Pain, 7, 261–271. doi:  10.1016/j.jpain.2005.10.011.CrossRefPubMedGoogle Scholar
  59. Smets, E. M., Garssen, B., Bonke, B., & De Haes, J. C. (1995). The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research, 39, 315–325. doi: 10.1016/0022-3999(94)00125-O CrossRefPubMedGoogle Scholar
  60. Sullivan, M. J. L., Bishop, S., & Pivik, J. (1995). The pain catastrophizing scale: Development and validation. Psychological Assessment, 7, 524–532. doi: 10.1037/1040-3590.7.4.524.CrossRefGoogle Scholar
  61. Tang, N. K. Y., Goodchild, C. E., & Salkovskis (2012). Hybrid cognitive-behaviour therapy for individuals with insomnia and chronic pain: A pilot randomized controlled trial. Behaviour Research and Therapy, 50, 814–820. doi: 10.1016/j.brat.2012.08.006 CrossRefPubMedGoogle Scholar
  62. Thieme, K., Turk, D. C., & Flor, H. (2007). Responder criteria for operant and cognitive behavioral treatment of fibromyalgia syndrome. Arthritis and Rheumatism, 57, 830–836. doi: 10.1002/art.22778 CrossRefPubMedGoogle Scholar
  63. Thomas, R. J. (2011). Sleep as a window into the world of fibromyalgia syndrome. Journal of Rheumatology, 38, 2499–2500. doi: 10.3899/jrheum.111314 CrossRefPubMedGoogle Scholar
  64. Turk, D. C., Vierck, C. J., Scarbrough, E., Crofford, L. J., & Rudin, N. J. (2008). Fibromyalgia: Combining pharmacological and nonpharmacological approaches to treating the person, not just the pain. The Journal of Pain, 9, 99–104. doi:  10.1016/j.jpain.2007.08.006 CrossRefPubMedGoogle Scholar
  65. van Koulil, S., van Lankveld, W., Kraaimaat, F. W., van Helmond, T., Vedder, A., van Hoorn, H.,. .. & Evers, A. W. (2008). Tailored cognitive-behavioral therapy for fibromyalgia: Two case studies. Patient Education and Counseling, 71, 308–314. doi: 10.1016/j.pec.2007.11.025 CrossRefPubMedGoogle Scholar
  66. Vitiello, M., McCurry, S. M., Shortreed, S., Barker, L., Rybarczyk, B. D., Keefe, F. J., & Von Korff, M. (2014). Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia. Pain, 155, 1547–1554. doi: 10.1016/j.pain.2014.04.032 CrossRefPubMedPubMedCentralGoogle Scholar
  67. Vitiello, M. V., McCurry, S. M., Shortreed, S. M., Balderson, B. H., Baker, L. D., Keefe, F. J.,. .. & Von Korff, M. (2013). Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: The lifestyles randomized controlled trial. Journal of the American Geriatrics Society, 61, 947–956. doi:  10.1111/jgs.12275 CrossRefPubMedPubMedCentralGoogle Scholar
  68. Vitiello, M. V., Rybarczyk, B., Von Korff, M., & Stepanski, E. J. (2009). Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. Journal of Clinical Sleep Medicine, 5, 355–362.PubMedPubMedCentralGoogle Scholar
  69. Vlaeyen, J. W. S., & Linton, S. J. (2012). Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain, 153, 1144–1147. doi: 10.1016/j.pain.2011.12.009 CrossRefPubMedGoogle Scholar
  70. Von Bülow, C., Amris, K., Bandak, E., Danneskiold-Samsøe, B., & Wæhrens, E. E. (2017). Improving activities of daily living ability in women with fibromyalgia: An exploratory, quasi-randomized, phase-two study, improve trial. Journal of Rehabilitation Medicine, 49, 241–250. doi:  10.2340/16501977-2198 CrossRefGoogle Scholar
  71. Von Korff, M., Vitiello, M., McCurry, S., Balderson, B. H., Moore, A., Baker, L.,. . .& Saunders, K. (2012). Group intervention for co-morbid insomnia and osteoarthritis pain in primary care: The lifestyles cluster randomized trial design. Contemporary Clinical Trials, 33, 759–768. doi: 10.1016/j.cct.2012.03.010 CrossRefGoogle Scholar
  72. Wagner, J., DiBonaventura, M. D., Chandran, A. B., & Cappelleri, J. C. (2012). The association of sleep difficulties with health-related quality of life among patients with fibromyalgia. BMC Musculoskeletal Disorders, 13, 199. doi: 10.1186/1471-2474-13-199 CrossRefPubMedPubMedCentralGoogle Scholar
  73. Wolfe, F., Clauw, D. J., Fitzcharles, M. A., Goldenberg, D. L., Katz, R. S., Mease, P.,. .. & Yunus, M. B. (2010). The American college of rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care and Research, 62, 600–610. doi: 10.1002/acr.20140 CrossRefPubMedGoogle Scholar
  74. Wolfe, F., Smythe, H. A., Yunus, M. B., Benett, M. R., Bombardier, C., Goldenberg, D.,. .. & Sheon, R. P. (1990). The American college of rheumatology 1990 criteria for the classification of fibromyalgia: Report of the multicenter criteria committee. Arthritis and Rheumatism, 33, 160–172.CrossRefPubMedGoogle Scholar
  75. Wolfe, F., Walitt, B. T., Katz, R. S., & Häuser, W. (2014). Symptoms, the nature of fibromyalgia, and diagnostic and statistical manual 5 (DSM-5) defined mental illness in patients with rheumatoid arthritis and fibromyalgia. PLoS ONE, 9, e88740. doi:  10.1371/journal.pone.0088740 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© 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

Personalised recommendations