Insomnia—trouble falling asleep, staying asleep, or waking up too early—is a common condition in older adults.
Sleeplessness can be exacerbated by osteoarthritis, the most common form of arthritis causing joint pain.
While there are effective therapies for treating insomnia in older adults, many people cannot get the treatment they need because they live in areas with limited access to health care, either in person or over the internet.
In a new study, researchers found that effective treatment for insomnia can be delivered in a few short phone calls.
The phone-delivered therapy, which consisted of guided training and education to combat insomnia, also helped reduce fatigue as well as pain linked to osteoarthritis.
The research was conducted by a team at the University of Washington and elsewhere.
In the study, the team tracked 327 people over 60 years old with moderate to severe insomnia from 2016 to 2018. The patients were interviewed six times for 20 to 30 minutes over an eight-week period.
Roughly half of the patients received materials and guided training called cognitive behavioral therapy for insomnia.
The remaining patients were in a control group, which received education-only phone calls that did not include the CBT-I therapy.
The key task of the therapy sessions was to guide patients through routines, information and self-monitoring in order to get their homeostatic sleep drive, which is the internal drive to sleep that is dissipated during the night and builds up during the day, and circadian rhythms, the complex and innate cycles of biochemical, physiological and behavioral processes, working together so that the patient will sleep at night and be wakeful during the daytime.
The phone-based therapy also helped patients reduce anxiety related to sleeplessness.
The study was the first large trial of a statewide population of older adults with chronic osteoarthritis who were randomly assigned to either the treatment or a control group.
The authors concluded that the phone-based treatment benefits for insomnia were “large, robust” and sustained for a year, even for patients with more severe insomnia and pain symptoms.
The study also found a reduction of those pain symptoms, although the pain reductions did not last a full year.
One author of the study is M. McCurry, a research professor in the UW School of Nursing
The study is published in JAMA Internal Medicine.
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