A Preliminary Examination of the Effects and Mechanisms of Cognitive Behavioral Therapy for Insomnia on Systemic Inflammation Among Patients with Knee Osteoarthritis.
| Autor: | Mun, Chung Jung, Speed, Traci J., Finan, Patrick H., Wideman, Timothy H., Quartana, Phillip J., Smith, Michael T. |
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| Předmět: |
INSOMNIA treatment
KNEE osteoarthritis CLINICAL psychology PREDICTION models BODY mass index RESEARCH funding BLIND experiment TREATMENT effectiveness RANDOMIZED controlled trials DESCRIPTIVE statistics CHI-squared test SLEEP duration SLEEP PAIN COGNITIVE therapy INFLAMMATION COMPARATIVE studies CYTOKINES SOCIODEMOGRAPHIC factors INTERLEUKINS PATIENT aftercare SLEEP hygiene REGRESSION analysis EVALUATION |
| Zdroj: | International Journal of Behavioral Medicine; Apr2024, Vol. 31 Issue 2, p305-314, 10p |
| Abstrakt: | Background: Systemic inflammation, particularly the elevation of interleukin-6 (IL-6), plays an important role in the maintenance and progression of knee osteoarthritis. Insomnia, being highly prevalent in knee osteoarthritis, is understood to be a risk factor for systemic inflammation. The present study examined if cognitive behavioral therapy for insomnia (CBT-I) would reduce circulating IL-6 levels to a larger extent than the active control condition via greater improvement in sleep maintenance disturbance at mid-treatment, among individuals with knee osteoarthritis and insomnia disorder. Methods: This is an ancillary study (N = 64) from a larger double-blind, randomized, active controlled clinical trial. Serum IL-6 was measured at baseline, post-treatment, and 3- and 6-month follow-ups. Sleep was measured by daily sleep diaries. Results: Overall, there was no significant IL-6 trajectory differences between CBT-I and the active control (p =.64). Compared to the active control, CBT-I demonstrated greater improvement in sleep maintenance disturbance at mid-treatment (p =.01), which, in turn, was significantly associated with lower levels of IL-6 at 3-month follow-up (p <.05). Sleep maintenance disturbance at mid-treatment did not significantly predict changes in IL-6 levels at post-treatment (p =.43) and 6-month follow-up (p =.90). Conclusions: Our study demonstrates that CBT-I can be efficacious in improving sleep maintenance disturbance among individuals with knee osteoarthritis and insomnia disorder. However, no convincing evidence was found that CBT-I can substantially reduce IL-6 levels via improvement in sleep. CBT-I alone may not be effective in reducing systematic inflammation in this clinical population. Trial Registration: NCT00592449. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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