Cognitive behavioral therapy is effective and decreases clinical pain for patients with insomnia and knee osteoarthritis.
Michael T. Smith, PhD, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a randomized trial of CBT-I in 100 patients with knee osteoarthritis and insomnia (mean age, 59.4 ± 9.5 years). Patients were randomly allocated in a 1:1 ratio to receive eight sessions of CBT-I or behavioral desensitization (placebo).
The researchers observed substantial improvement in sleep in both groups of patients in intent-to-treat analyses. Significantly greater reductions in wake after sleep onset were seen for patients in the CBT-I group, as measured by patient diary and polysomnography. In both groups, patients reported significant and comparable reductions in pain over six months; one-third reported a pain severity reduction of 30%.