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Behavioral Therapy for Insomnia in Fibromyalgia Sufferers

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A study is currently recruiting patients to test the effectiveness of a non-drug treatment for the insomnia that often accompanies FM.

Although over 50 million Americans suffer from sleep disorders, including insomnia, excessive drowsiness, sleep apnea, and restless movement during sleep, for fibromyalgia (FM) sufferers, it’s an all-too-common symptom of their medical condition.

The vast majority of FM sufferers’ experience persistent sleep disturbances (e.g. unable to fall asleep, repeated or extended awakenings, unable to fall back to sleep once awoken). These disturbances can worsen other FM-related symptoms such as chronic pain and fatigue. In addition, while antidepressants and hypnotic drugs may help alleviate some FM sufferers’ symptoms, little has been found to help improve their quality of sleep on a long-term basis.

Over the past decade, researchers have developed, refined, and repeatedly tested a cognitive-behavioral therapy (CBT), which has proven effective for reducing sleep disturbances. Initial work suggests that factors common among other insomnia sufferers such as conditioned bedtime arousal, erratic sleep/wake scheduling, and spending too much time in bed is likely to add to a FM sufferers’ sleep problems as well.

A randomized clinical trial will be conducted to confirm these preliminary findings and to determine the effectiveness of CBT insomnia treatment for interrupting the disturbances that often plague FM sufferers’ sleep, including pain. A portion of this study will compare CBT with a contact control treatment and standard care. Patients will be tested at the beginning, middle, and end of the study. Follow-up testing will be conducted at six months. Patients will keep sleep logs and fill out an Insomnia Symptom Questionnaire and will be measured on their sleep improvement, pain, mood, and general quality of life. Researchers will also explore whether the normal/abnormal physiological activity monitored during the patient’s sleep prior to the study correlates with initial levels of pain/distress or eventual treatment outcome.

Researchers hope that results from this study provide useful information about treating FM-related sleep difficulties with CBT. Results should also improve the understanding of FM in general and provide new information about the potential role of behavioral therapy in the overall management of this disorder.

This study is being conducted by the VA Medical Center, Dept. of Psychiatry/Behavioral Science, 508 Fulton Street, Durham, NC, 27705. Contact Jack Edinger, Ph.D. at (919) 286-0411.

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