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Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: a randomized controlled trial

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Abstract

Sleep disturbances play an important role in the exacerbation of pain and other troubling symptoms reported by patients with fibromyalgia (FM). The objective of this trial was to analyze the efficacy of a cognitive-behavioral therapy for insomnia (CBT-I) versus a sleep hygiene (SH) education program at improving sleep and other clinical manifestations in FM. Sixty-four FM women with insomnia were randomly assigned to the CBT-I or the SH groups, and 59 completed the treatments (30 in the CBT-I group and 29 in the SH group). Participants completed several self-report questionnaires at pre-, post-treatment and follow-ups. The CBT-I group reported significant improvements at post-treatment in several sleep variables, fatigue, daily functioning, pain catastrophizing, anxiety and depression. The SH group only improved significantly in subjective sleep quality. Patients in the CBT-I group showed significantly greater changes than those in the SH group in most outcome measures. The findings underscore the usefulness of CBT-I in the multidisciplinary management of FM.

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Acknowledgments

This research was financially supported by the Spanish Ministry of Science and Innovation (research project SEJ2006-07513). CDP is supported by a FPU grant from the Spanish Ministry of Education (AP 2007-02965). Research by GBC is funded by Spanish Ministry of Science and Innovation grant (INNPACTO IPT300000-2010-10) and by Spanish Ministry of Education grant (EDU2010-21215).

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  1. Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja, s/n, 18071, Granada, Spain

    M. Pilar Martínez, Elena Miró, Ana I. Sánchez, Carolina Díaz-Piedra & Gualberto Buela-Casal

  2. Rheumatology Service, Virgen de las Nieves University Hospital, Granada, Spain

    Rafael Cáliz

  3. Faculty of Psychology and Educational Sciences, Research Group Health Psychology, University of Leuven, Leuven, Belgium

    Johan W. S. Vlaeyen

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  1. M. Pilar Martínez
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Martínez, M.P., Miró, E., Sánchez, A.I. et al. Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: a randomized controlled trial. J Behav Med 37, 683–697 (2014). https://doi.org/10.1007/s10865-013-9520-y

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