The impact on sleep of a multidisciplinary cognitive behavioural pain management programme: a pilot study

BMC Musculoskeletal Disorders

Study Protocol

Sheila Horan¹  Camillus K Power¹  Valerie Kelly¹  Orla Spencer¹  Declan O'Keeffe²  Jennifer M Cunningham³  Catherine Blake³  Brona M Fullen³ 

[1] Pain Service, Adelaide and Meath Hospital incorporating the National Children's Hospital, 24, Tallaght, Dublin, Ireland;Pain Service, St Vincent's University Hospital, Elm Park, 4, Dublin, Ireland;UCD School of Public Health, Physiotherapy and Population Science, Health Science Centre, Belfield Campus, Dublin, Ireland;

关键词: Sleep Disturbance;    Sleep Quality;    Pittsburgh Sleep Quality Index;    Sleep Onset Latency;    Subjective Sleep Quality;   

DOI  :  10.1186/1471-2474-12-5

 received in 2010-07-19, accepted in 2011-01-10,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundReduced sleep quality is a common complaint among patients with chronic pain, with 50-80% of patients reporting sleep disturbance. Improvements in pain and quality of life measures have been achieved using a multidisciplinary cognitive behavioural therapy pain management programme (CBT-PMP) that aims to recondition attitudes to pain, and improve patients' self-management of their condition. Despite its high prevalence in patients with chronic pain, there is very limited objective evidence for the effect of this intervention on sleep quality. The primary research objective is to investigate the short-term effect of a multidisciplinary CBT-PMP on subjective (measured by Pittsburg Sleep Quality Index) and objective sleep quality (measured by Actigraphy) in patients with chronic pain by comparison with a control group. The secondary objectives will investigate changes in function and mood, and then explore the relationship between objective and subjective sleep quality and physical and psychological outcome measures.Methods/DesignPatients who fulfil the inclusion criteria for attendance on the multidisciplinary CBT-PMP in the Adelaide and Meath Hospital, Tallaght, Dublin and are currently listed on the PMP waiting list will be invited to participate in this pilot study. Potential patients will be screened for sleep disturbance [determined by the Pittsburgh Sleep Quality Index (PSQI)]. Those patients with a sleep disturbance (PSQI >5) will be assigned to either the intervention group (immediate treatment), or control group (deferred treatment, i.e. the PMP they are listed for is more than six months away) based on where they appear on the waiting list. Baseline measures of sleep, function, and mood will be obtained using a combination of self-report questionnaires (the Hospital Anxiety and Depression Scale, the Short Form 36 health survey, the Pittsburgh Sleep Quality Index, the Tampa Scale for Kinesiophobia), and functional outcome measures. Sleep will be measured for seven days using actigraphy (Actiwatch 7). These measures will be repeated after the four week multidisciplinary cognitive behavioural therapy pain management programme, and at a two month follow-up. The waiting list control group will be assessed at baseline, and two months later. Analysis for the primary outcome will include between group differences of subjective and objective sleep parameters from baseline to follow-up using Independent T-tests or Mann-Whitney U tests. The secondary outcomes establishing relationships between the sleep variables and physical and psychological outcome measures will be established using multiple linear regression models.DiscussionThis pilot study will evaluate the impact of a multidisciplinary CBT-PMP on both subjective and objective measures of sleep in patients with chronic pain and provide guidance for a larger clinical trial.Trial RegistrationCurrent controlled trial ISRCTN: ISRCTN74913595

【 授权许可】

Unknown   
© Cunningham et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.