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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 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.

Langue : ANGLAIS

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