Individual beliefs can play a potential role in worsening insomnia and pain experiences in patients with chronic pain conditions like back pain, fibromyalgia and arthritis, a team of researchers has found. “I won’t be able to cope with my pain if I don’t sleep well,” is the common way patients with chronic pain conditions think, the researchers said.
“Thoughts can have a direct and/or indirect impact on our emotion, behaviour and even physiology. The way how we think about sleep and its interaction with pain can influence the way how we cope with pain and manage sleeplessness,” said Nicole Tang from the University of Warwick in Britain. While some of these beliefs are healthy and useful, others are rigid and misinformed. Such conditions can be effectively managed by cognitive-behavioural therapy (CBT), the study added.
Based on these beliefs, the team developed a scale, pain-related beliefs and attitudes about sleep (PBAS), to measure beliefs about sleep and pain. The scale, when tested on four groups of patients suffering from long-term pain and bad sleeping patterns, showed that people who believe they won’t be able to sleep as a result of their pain are more likely to suffer from insomnia, thus causing worse pain.
Current psychological treatments for chronic pain have mostly focused on pain management and a lesser emphasis on sleep. However, the “PBAS scale provides a useful clinical tool to assess and monitor treatment progress during these therapies”, noted Esther Afolalu from the University of Warwick.
The study has provided therapists the means with which one can identify and monitor rigid thoughts about sleep and pain that are sleep-interfering, allowing the application of the proven effective CBT for insomnia in people with chronic pain. With better sleep, pain problems are significantly reduced, especially after receiving a short course of CBT for both pain and insomnia, the researchers concluded.