Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines

Abstract

Objective/Background.-Insomnia commonly co-occurs with chronic migraines (CM). Non-pharmacological treatments for insomnia in CM patients remain understudied. This is a proof-of-concept study, which aims to evaluate the feasibility, acceptability, and preliminary efficacy of a digital cognitive behavioral therapy for insomnia (dCBT-I) for individuals with CM and insomnia (CM-I) in the United States.Methods.-We recruited 42 females with CM-I symptoms from a U.S.-based observational cohort and from the general population via advertisements. Within a multiple baseline design, participants were randomized to receive dCBT-I after 2, 4, or 6 weeks of completing baseline sleep diaries. DCBT-I was scrutinized against benchmarks for completion rates (≥90% to complete dCBT-I), acceptability (≥80% to find dCBT-I acceptable), and posttreatment changes in insomnia symptoms (≥50% indicating a clinically relevant improvement in their insomnia symptoms). As a secondary measure, we also reported percentage of individuals reverting to episodic migraines. Results.-Out of 42 randomized, 35 (83.3%) completed dCBT-I within the 12 weeks provided. Of these completers, 33 (94.3%) reported being satisfied (n = 16) or very satisfied (n = 17) with treatment. Additionally, 65.7% of completers responded to treatment as per universally accepted criteria for insomnia. Lastly, 34% of completers reverted from CM to episodic migraine. Conclusion.-This study provides evidence for the feasibility and acceptability of dCBT-I in patients with CM-I complaints. Effects of improving insomnia and migraines were suggested. These results indicate that a randomized controlled trial is needed to determine the efficacy of dCBT-I in CM patients.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Chronic migraine treatment: multidisciplinary approach. Case report

“…Выяснено, что инсомния -фактор учащения приступов мигрени [4]. В нескольких исследованиях, включавших пациентов с ХМ и ХИ, показано, что нормализация сна с помощью КПТ способствует трансформации мигрени из хронической в эпизодическую [17][18][19][20]. Ранее при ведении пациентки Н. инсомнию и тревогу не диагностировали и не лечили.…”

“…Когнитивно-поведенческая терапия (КПТ) доказала свою эффективность в лечении хронической инсомнии (ХИ) [8,9], тревожных расстройств [10], депрессии [11], хронической боли в спине [12]. Проводятся исследования по эффективности КПТ при ХМ [13][14][15][16][17][18][19][20].…”

Current Perspectives on the Impact of Chronic Migraine on Sleep Quality: A Literature Review

“… 12 Digital cognitive therapy was applied for 12 weeks to patients with insomnia and CM significantly improved insomnia. 91 …”

Nightmares in Migraine: A Focused Review

“…More widespread use, ease of administration, and limited unwanted side effects or complications of nonpharmacological interventions have made these a starting point for treatments that can be applied as lifelong strategies, if required. For example, the successful use of cognitive behavioral therapy (CBT) and its effectiveness for comorbid conditions of chronic pain and sleep disorders [ 96 ] has been expanded to chronic headaches [ 97 ], including migraine [ 53 , 98 , 99 ]. There is ample evidence that psychological approaches to headaches are effective, and a behavioral approach called learning to cope with triggers (LCT) has been effective for chronic headaches [ 100 ].…”