Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice

Among people with chronic pain, insomnia is highly prevalent, closely related to the mechanism of central sensitization, characterized by low-grade neuroinflammation, and commonly associated with stress or anxiety; in addition, it often does not respond effectively to drug treatments. This review ar...

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Bibliographic Details
Published inPhysical therapy Vol. 98; no. 5; pp. 325 - 335
Main Authors Nijs, Jo, Mairesse, Olivier, Neu, Daniel, Leysen, Laurence, Danneels, Lieven, Cagnie, Barbara, Meeus, Mira, Moens, Maarten, Ickmans, Kelly, Goubert, Dorien
Format Journal Article
LanguageEnglish
Published United States Oxford University Press 01.05.2018
Subjects
Analysis
Arthritis
Back pain
Behavior modification
Cancer therapies
Care and treatment
Chronic fatigue syndrome
Chronic illnesses
Chronic pain
Clinical medicine
Cognition & reasoning
Comorbidity
Complications and side effects
Diagnosis
Exercise
Insomnia
Nervous system
Neurobiology
Neurosciences
Pain management
Physical fitness
Physical therapists
Physical therapy
Practice
Sleep
Sleep disorders
Systematic review
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Summary:Among people with chronic pain, insomnia is highly prevalent, closely related to the mechanism of central sensitization, characterized by low-grade neuroinflammation, and commonly associated with stress or anxiety; in addition, it often does not respond effectively to drug treatments. This review article applies the current understanding of insomnia to clinical practice, including assessment and conservative treatment of insomnia in people with chronic pain. Cognitive-behavioral therapy for insomnia can be efficacious for improvements in sleep initiation, sleep maintenance, perceived sleep quality, and pain interference with daily functioning in people with chronic pain. A recent systematic review concluded that with additional training, physical therapist-led cognitive-behavioral interventions are efficacious for low back pain, allowing their implementation within the field. Cognitive-behavioral therapy for insomnia, as provided to people with chronic pain, typically includes education, sleep restriction measures, stimulus control instructions, sleep hygiene, and cognitive therapy.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ObjectType-Review-1
ISSN:0031-9023
1538-6724
DOI:10.1093/ptj/pzy020