Cognitive-behavioral therapy for insomnia (CBT-I) has emerged as an effective treatment and requires widespread implementation, mainly in rural areas that lack proper medical facilities. This study aims to compare the effectiveness of telephone CBT-I versus education-only control (EOC) in older adults with insomnia associated with moderate-severe osteoarthritis pain.
This randomized clinical trial included a total of 327 patients aged 60 or older who had moderate to severe insomnia and osteoarthritis (OA) pain symptoms. The researchers conducted blinded assessments at baseline. The patients were assigned to six 20-30-minute telephone sessions (CBT-I) or information about insomnia and OA (EOC). The primary outcome of the study was the score on the Insomnia Severity Index (ISI) at two months.
Of 327 participants included in the trial, follow-up data for 282 participants were available. The findings suggested that two months after the treatment, the ISI scores decreased by 9.1 points in the CBT-I group and 4.8 points in the EOC group, exhibiting an adjusted mean difference of –3.5 points. At a follow-up of 12 months, 67 of 119 participants receiving CBT-I remained in remission, compared with 33 of 128 in the EOC group.
The research concluded that CBT-I was more effective than EOC in improving sleep in patients with OA and insomnia.