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

Martínez, María Pilar; Miró, Elena; Sánchez, Ana María; Díaz-Piedra, Carolina; Cáliz, Rafael; Vlaeyen, Johan W.S.; Buela-Casal, Gualberto

doi:10.1007/s10865-013-9520-y

Cited by 120 publications

(125 citation statements)

References 54 publications

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“…Only one study had a total treatment time <5 h (Ang et al, 2010) and seven studies had a treatment time of >25 h (Wigers et al, 1996;Soares and Grossi, 2002;Thieme et al, 2003;Thieme et al, 2006;Falcao et al, 2008;Castel et al, 2012;Karlsson et al, 2015). The remaining studies had a treatment time between 5 and 25 h. Fourteen studies reported on average attendance rates of participants (Wigers et al, 1996;Oliver et al, 2001;King et al, 2002;Redondo et al, 2004;Thieme et al, 2006;Rooks et al, 2007;Alda et al, 2011;Luciano et al, 2011Luciano et al, , 2014Miro et al, 2011;Castel et al, 2012;Parra-Delgado and Latorre-Postigo, 2013;Martınez et al, 2014;Karlsson et al, 2015). The median of attended CBTs sessions was 77% (range 42-93%).…”

Section: Methodsmentioning

confidence: 99%

“…One of these studies was included in the first version of the review (Williams et al, 2010). We included seven new studies (Williams et al, 2002;Parra-Delgado and Latorre-Postigo, 2013;Wicksell et al, 2013;Luciano et al, 2014;Martınez et al, 2014;Garcia-Palacios et al, 2015;Karlsson et al, 2015).One study (Williams et al, 2002) was not included in the first version of this review. These studies added 546 new participants.…”

Section: Searchmentioning

confidence: 99%

“…Eighteen studies were conducted in Europe (Burckhardt et al, 1994;Vlaeyen et al, 1996;Wigers et al, 1996;Soares and Grossi, 2002;Thieme et al, 2003Thieme et al, , 2006Redondo et al, 2004;Castel et al, 2009Castel et al, , 2012Alda et al, 2011;Luciano et al, 2011Luciano et al, , 2014Miro et al, 2011;Parra-Delgado and Latorre-Postigo, 2013;Wicksell et al, 2013;Martınez et al, 2014;Garcia-Palacios et al, 2015;Karlsson et al, 2015), of which 10 were conducted in Spain (Redondo et al, 2004;Castel et al, 2009Castel et al, , 2012Alda et al, 2011;Luciano et al, 2011Luciano et al, , 2014Miro et al, 2011;ParraDelgado and Latorre-Postigo, 2013;Martınez et al, 2014;Garcia-Palacios et al, 2015), five in Scandinavian countries (Burckhardt et al, 1994;Wigers et al, 1996;Soares and Grossi, 2002;Wicksell et al, 2013;Karlsson et al, 2015), two studies in Germany (Thieme et al, 2003(Thieme et al, , 2006 and one study in the Netherlands (Vlaeyen et al, 1996). Ten studies were conducted in North America (USA) (Nicassio et al, 1997;Oliver et al, 2001;King et al, 2002...…”

Section: Settingsmentioning

confidence: 99%

“…All studies but one (Thieme et al, 2003) were outpatient-based. Most studies reported the setting in which CBTs were delivered: four studies in primary care settings (Rooks , 2007;Alda et al, 2011;Luciano et al, 2011;Karlsson et al, 2015), by six studies in rheumatology clinics (Burckhardt et al, 1994;Thieme et al, 2003;Redondo et al, 2004;Kashikar-Zuck et al, 2005Woolfolk et al, 2012) by two studies each in pain clinics (Castel et al, 2009(Castel et al, , 2012, psychology departments (Thieme et al, 2006;Martınez et al, 2014) and rehabilitation clinics (Vlaeyen et al, 1996;King et al, 2002) and by one study in the home of the patients (Ang et al, 2010). All studies except six (Oliver et al, 2001;Rooks et al, 2007;Alda et al, 2011;Luciano et al, 2011Luciano et al, , 2014Kashikar-Zuck et al, 2012) were single-centre studies.…”

Section: Settingsmentioning

confidence: 99%

“…Twenty-three studies provided traditional CBT (Burckhardt et al, 1994;Vlaeyen et al, 1996;Wigers et al, 1996;Nicassio et al, 1997;King et al, 2002;Soares and Grossi, 2002;Williams et al, 2002;Redondo et al, 2004;Edinger et al, 2005;Kashikar-Zuck et al, 2005;Thieme et al, 2006;Falcao et al, 2008;Castel et al, 2009Castel et al, , 2012Ang et al, 2010;Alda et al, 2011;Luciano et al, 2011;Miro et al, 2011;Kashikar-Zuck et al, 2012;Woolfolk et al, 2012;Martınez et al, 2014;Garcia-Palacios et al, 2015;Karlsson et al, 2015), three studies offered acceptance/mindfulness-based therapy (Parra-Delgado and Latorre-Postigo, 2013; Wicksell et al, 2013;Luciano et al, 2014) and two studies each provided self management education (Oliver et al, 2001;Rooks et al, 2007) and operant therapy (Thieme et al, 2003(Thieme et al, , 2006. All studies were conducted by live face-toface contact except one study which was delivered by telephone (voice-to-voice) (Ang et al, 2010).…”

Section: Types Of Cbtsmentioning

confidence: 99%

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Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta‐analysis of randomized controlled trials

Bernardy

Klose

Welsch

et al. 2017

European Journal of Pain

173

122

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This updated systematic review aimed at evaluating the efficacy, acceptability and safety of cognitive behavioural therapies (CBTs) in fibromyalgia syndrome (FMS). Clinicaltrials.gov, Cochrane Library, MEDLINE, PsycINFO and SCOPUS were searched from September 2013 to May 2017. Randomized controlled trials (RCTs) comparing CBTs with controls were analysed. Primary outcomes were ≥50% pain relief, ≥20% improvement of health‐related quality of life (HRQoL), negative mood, fatigue, disability, acceptability and safety at end of therapy and at 6 months follow‐up. Effects were summarized by a random effects model using risk differences (RD) or standardized mean differences (SMD) with 95% confidence intervals (CI). 29 RCTs with 2509 subjects were included. CBTs were superior to controls (waiting list, attention control, treatment as usual, other active non‐pharmacological therapies) in pain relief of 50% or greater (RD 0.05 [95% CI 0.02–0.07] (high‐quality evidence), improvement of HRQoL of 20% or greater (RD 0.13 [95% CI 0.00–0.26], (moderate quality evidence), and in reducing negative mood (SMD −0.43 [95% CI −0.62 to −0.24]) (high‐quality evidence), disability (SMD −0.30 [95% CI −0.52 to −0.08]) (high‐quality evidence) and fatigue (SMD – 0–27 [95% CI −0.50 to −0.03]) (high‐quality evidence). There were no statistically significant differences between CBTs and controls in acceptability and safety (high‐quality evidence). The update did not change the major findings of the previous review. CBTs provided a clinically relevant benefit over control interventions in reducing some key symptoms of FMS and disability at the end of treatment. Significance This updated systematic review with meta‐analysis on cognitive behavioural therapies (CBTs) including acceptance‐based CBTs endorse the efficacy and tolerability of CBTs in reducing key symptoms and disability in FMS in the short‐ and long‐term if compared to waiting list, treatment as usual, attention controls and active non‐pharmacological therapies. CBTs did not differ in efficacy except superiority for coping with pain and tolerability from recommended drug therapy (pregabalin and/or duloxetine).

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Section: Methodsmentioning

confidence: 99%

Section: Searchmentioning

confidence: 99%

Section: Settingsmentioning

confidence: 99%

Section: Settingsmentioning

confidence: 99%

Section: Types Of Cbtsmentioning

confidence: 99%

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Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta‐analysis of randomized controlled trials

Bernardy

Klose

Welsch

et al. 2017

European Journal of Pain

173

122

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Cognitive Behavioral Therapy for Insomnia Comorbid With Psychiatric and Medical Conditions

et al. 2015

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IMPORTANCE Cognitive behavioral therapy for insomnia (CBT-I) is the most prominent nonpharmacologic treatment for insomnia disorders. Although meta-analyses have examined primary insomnia, less is known about the comparative efficacy of CBT-I on comorbid insomnia.OBJECTIVE To examine the efficacy of CBT-I for insomnia comorbid with psychiatric and/or medical conditions for ( 1) remission from insomnia; (2) self-reported sleep efficiency, sleep onset latency, wake after sleep onset, total sleep time, and subjective sleep quality; and (3) comorbid symptoms. DATA SOURCES A systematic search was conducted on June 2, 2014, through PubMed, PsycINFO, the Cochrane Library, and manual searches. Search terms included (1) CBT-I or CBT or cognitive behavioral [and its variations] or behavioral therapy [and its variations] or behavioral sleep medicine or stimulus control or sleep restriction or relaxation therapy or relaxation training or progressive muscle relaxation or paradoxical intention; and (2) insomnia or sleep disturbance.STUDY SELECTION Studies were included if they were randomized clinical trials with at least one CBT-I arm and had an adult population meeting diagnostic criteria for insomnia as well as a concomitant condition. Inclusion in final analyses (37 studies) was based on consensus between 3 authors' independent screenings. DATA EXTRACTION AND SYNTHESIS Data were independently extracted by 2 authors and pooled using a random-effects model. Study quality was independently evaluated by 2 authors using the Cochrane risk of bias assessment tool. MAIN OUTCOMES AND MEASURESA priori main outcomes (ie, clinical sleep and comorbid outcomes) were derived from sleep diary and other self-report measures.RESULTS At posttreatment evaluation, 36.0% of patients who received CBT-I were in remission from insomnia compared with 16.9% of those in control or comparison conditions (pooled odds ratio, 3.28; 95% CI, 2.30-4.68; P < .001). Pretreatment and posttreatment controlled effect sizes were medium to large for most sleep parameters (sleep efficiency: Hedges g = 0.91 [95% CI, 0.74 to 1.08]; sleep onset latency: Hedges g = 0.80 [95% CI, 0.60 to 1.00]; wake after sleep onset: Hedges g = 0.68; sleep quality: Hedges g = 0.84; all P < .001), except total sleep time. Comorbid outcomes yielded a small effect size (Hedges g = 0.39 [95% CI, 0.60-0.98]; P < .001); improvements were greater in psychiatric than in medical populations (Hedges g = 0.20 [95% CI, 0.09-0.30]; χ 2 test for interaction = 12.30; P < .001). CONCLUSIONS AND RELEVANCECognitive behavioral therapy for insomnia is efficacious for improving insomnia symptoms and sleep parameters for patients with comorbid insomnia. A small to medium positive effect was found across comorbid outcomes, with larger effects on psychiatric conditions compared with medical conditions. Large-scale studies with more rigorous designs to reduce detection and performance bias are needed to improve the quality of the evidence.

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Cognitive behavioural therapies for fibromyalgia

Bernardy

Klose

Busch

et al. 2013

Cochrane Database of Systematic Reviews

176

151

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

Cited by 120 publications

References 54 publications

Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta‐analysis of randomized controlled trials

Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta‐analysis of randomized controlled trials

Cognitive Behavioral Therapy for Insomnia Comorbid With Psychiatric and Medical Conditions

Cognitive behavioural therapies for fibromyalgia

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