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Behavioral Insomnia Therapy for Fibromyalgia Patients

In a study funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and led by Jack Edinger, Ph.D. investigators evaluated the effectiveness of cognitive-behavioral therapy for insomnia in fibromyalgia patients.

Sleep disorders, including insomnia, are common in people with fibromyalgia. To determine whether cognitive behavioral therapies might improve insomnia in fibromyalgia patients, investigators enrolled 47 people with fibromyalgia in the study. Cognitive behavioral therapies in this study mean therapies designed to educate people about sleep and to correct bad sleep habits and improper sleep scheduling. Participants were randomized into groups, each employing one of the following therapies:
* Cognitive behavioral therapy,
* Usual care (typically medications) from the doctor treating their fibromyalgia,
* Sleep hygiene, which includes, for example, instructions to limit caffeine, increase exercise, avoid alcohol close to bedtime, and keep the bedroom dark and quiet.

All participants also kept sleep logs and answered questionnaires before and after treatment about their insomnia symptoms, their beliefs and attitudes about sleep, and the extent to which they felt they could control their sleep problems.

To date, the researchers have analyzed data from the first 41 study participants, and they show trends suggesting that cognitive behavioral therapy are more effective than the other treatments. For example, the researchers' analysis of the sleep log data showed that people in the cognitive behavioral therapy group experienced more improvement in how long they slept than the other two groups. The analysis of the questionnaire data showed that those in both the cognitive behavioral therapy group and the sleep hygiene group had significantly greater improvements in their subjective insomnia symptoms than did the group receiving usual care.