More Sleep for Pain Management

Overseen By Margeaux Gray, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Penn State University

Must not be taking: Sleep medications, Pain medications

Disqualifiers: Sleep disorder, Pain disorder, Hypertension, Cardiovascular disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

45 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether an additional hour of sleep each night for a week can help people manage pain better. Participants will wear special watches to monitor their sleep and heart rate, while researchers test their responses to pressure and cold pain. Ideal candidates are English-speaking young adults without sleep or pain disorders and not currently taking sleep or pain medications. As an unphased trial, this study allows participants to contribute to groundbreaking research on sleep and pain management.

Will I have to stop taking my current medications?

The trial requires that you do not start any new treatments for sleep or pain during the study, but it does not specify if you need to stop current medications. However, if you are taking medications directed by a doctor for sleep or pain, you may not be eligible to participate.

What prior data suggests that sleep extension is safe for pain management?

Research shows that getting more sleep is generally safe and often beneficial for health. Studies have found that increased sleep can reduce pain perception.

There is little evidence of harm from sleeping more. In fact, other studies suggest that more sleep usually leads to positive outcomes. It naturally supports both body and mind, and most people tolerate it well.

Therefore, for those considering joining a study to increase sleep, research suggests it should be safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about sleep extension for pain management because it offers a natural approach to alleviating pain without medication. Unlike standard treatments like pain relievers or physical therapy, sleep extension simply involves spending more time in bed to potentially boost the body's natural healing processes. This method stands out because it avoids the side effects often associated with medications and represents an accessible, low-cost option that anyone can try. By understanding the link between increased sleep and pain relief, researchers hope to uncover a powerful, non-invasive tool for managing pain.

What evidence suggests that sleep extension might be an effective treatment for pain management?

This trial will evaluate the effects of Sleep Extension, where participants increase their time in bed by more than one hour for a week, on pain management. Research has shown that more sleep might reduce sensitivity to pain. One study found that sleeping longer can increase pain tolerance, even though it doesn't change the threshold at which pain begins. Another study found that more sleep can reduce tiredness, potentially helping manage pain indirectly. While non-drug methods like increased sleep can reduce pain, anxiety, and depression in the short term, the long-term benefits remain uncertain. Overall, sleeping more might improve coping with pain, even if it doesn't alter the pain threshold. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for young adults aged 18 to 24 who speak and read English fluently. Participants should not start any new treatments for sleep or pain during the study. They'll need to wear monitoring devices and have their pain tolerance tested.

Inclusion Criteria

I agree not to start any new treatments for sleep or pain during the study.

Fluent English speaker and reader

Exclusion Criteria

I have been diagnosed with a sleep disorder.

Pregnant

Current smoker

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

Baseline

Participants maintain their usual sleep behavior for baseline measurement

1 week

1 visit (in-person)

Intervention

Participants extend sleep by at least an hour per night

1 week

1 visit (in-person)

Follow-up

Participants are monitored for changes in pain response and sleep patterns

1 week

What Are the Treatments Tested in This Trial?

Interventions

• Sleep extension

Trial Overview The study tests if sleeping at least one extra hour each night over a three-week period can increase a person's ability to tolerate pain. Pain response will be measured using pressure and cold stimuli in scheduled visits.

How Is the Trial Designed?

Group I: Sleep Extension Experimental Treatment 1 Intervention

1 week of \>1 hour increased time in bed

Group II: Control Active Control 1 Intervention

Sustained sleep behavior

Who Is Running the Clinical Trial?

Penn State University

Lead Sponsor

Trials

380

Recruited

131,000+

Published Research Related to This Trial

The feasibility trial involving 25 adults with chronic pain and insomnia showed that 64% of participants completed all sessions of the Hybrid CBT, indicating a reasonable level of adherence to this intensive therapy.

Qualitative feedback from participants revealed satisfaction with the Hybrid CBT content, but suggested improvements such as reducing session length and increasing therapist contact, which could enhance adherence in future trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Implementing a hybrid cognitive-behavioural therapy for pain-related insomnia in primary care: lessons learnt from a mixed-methods feasibility study. Tang, NKY., Moore, C., Parsons, H., et al.[2021]

The Pain Sleep questionnaire (PS-20) was developed and validated for measuring pain-related sleep disturbances in 125 pain clinic patients, demonstrating excellent internal consistency with a Cronbach's alpha of 0.969.

The PS-20 effectively correlates with physical health measures, indicating its reliability and validity as a tool for assessing how pain affects sleep quality in patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Development and evaluation of a patient-reported outcome measure of pain-related sleep disturbances for pain clinic patients]. Morita, Y., Iseki, M., Ifuku, M., et al.[2022]

Cognitive Behavioral Therapy for Insomnia (CBT-I) significantly improves sleep quality in adults with chronic pain, with a strong effect size observed in a meta-analysis of 9 studies involving 385 participants.

While CBT-I also helps reduce pain, anxiety, and depression post-treatment, the long-term benefits are unclear, and sleep hygiene interventions were found to be ineffective in comparison.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of non-pharmacological sleep interventions for people with chronic pain: a systematic review and meta-analysis. Whale, K., Dennis, J., Wylde, V., et al.[2022]

Sleep deprivation is linked to a range of serious health issues, including mental health problems, obesity, and chronic diseases, with a particularly strong connection to chronic pain and musculoskeletal conditions.

Between 67% and 88% of individuals with chronic pain experience sleep disruptions, indicating that improving sleep quality could significantly benefit their pain management and overall health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Importance of Sleep for People With Chronic Pain: Current Insights and Evidence. Whale, K., Gooberman-Hill, R.[2022]

In a study of 38 adults with sleep duration less than 7 hours, the combination of a Fitbit and coaching showed potential for improving sleep duration, although the results were not statistically significant compared to a self-management control group.

Coaching alone led to significant improvements in sleep-related impairment, highlighting that while all interventions were feasible and acceptable, the added accountability from coaching may enhance the effectiveness of sleep extension strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A feasibility study to understand the components of behavioral sleep extension. Baron, KG., Trela-Hoskins, SR., Duffecy, J., et al.[2023]

In a study involving 90 patients with severe chronic back pain, the use of an adjustable airbed for 28 nights resulted in significant improvements, with 95% of participants reporting reduced pain and 88% experiencing better sleep quality.

The adjustable airbed was preferred by 85% of participants, and it showed substantial benefits in health status measures, indicating it could be an effective adjunct to traditional therapies for managing chronic back pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Short-term outcomes of chronic back pain patients on an airbed vs innerspring mattresses. Monsein, M., Corbin, TP., Culliton, PD., et al.[2015]

A review of 19 studies on patient-reported outcome measures (PROMs) for assessing sleep quality in adults with pain-related conditions found that the Jenkins Sleep Scale (JSS), Pittsburgh Sleep Quality Scale (PSQI), and Medical Outcomes Study-Sleep Scale (MOS-SS) were the most frequently evaluated, highlighting their relevance in this context.

The review indicated that while the JSS and MOS-SS showed sufficient content and structural validity, there is still a need for further investigation into the reliability and responsiveness of these measures, particularly in chronic pain conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measurement properties of Patient-Reported Outcome Measures used to assess the sleep quality in adults with high prevalence chronic pain conditions: a systematic review. Phelps, C., Bellon, S., Hinkey, M., et al.[2021]

The Chronic Pain Sleep Inventory (CPSI) was validated in a study involving 2674 patients with chronic pain, showing that it effectively measures sleep problems related to pain, particularly through three key items.

The CPSI demonstrated strong construct validity and reliability, indicating it can reliably assess sleep issues in chronic pain patients, which may help in evaluating treatment outcomes for pain relief and its impact on sleep quality.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychometric testing and validation of the Chronic Pain Sleep Inventory. Kosinski, M., Janagap, CC., Gajria, K., et al.[2022]

A cognitive behavioral pain management program significantly improved sleep quality in patients with chronic pain, particularly reducing the number of wake bouts, as shown by a large treatment effect (d = 0.76) compared to a waiting list control group.

The study involved 46 participants (24 in the intervention group and 22 in the control group) and utilized both self-reported and objective sleep measures, indicating that cognitive behavioral therapy may be a beneficial approach for addressing sleep disturbances in chronic pain patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of a Cognitive Behavioral Pain Management Program on Sleep in Patients with Chronic Pain: Results of a Pilot Study. Blake, C., Cunningham, J., Power, CK., et al.[2018]

In a study of 27 healthy individuals, extending sleep by an average of 2 hours per night increased pain tolerance beyond baseline levels, indicating that more sleep can help people handle pain better.

However, while sleep extension did not change pain threshold, those who typically get less sleep than they need (lower sleep credit) showed greater improvements in pain tolerance, suggesting that sleep debt may significantly affect how we experience pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sleep extension reduces pain sensitivity. Simonelli, G., Mantua, J., Gad, M., et al.[2022]

Citations

1. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1389945718304350

Sleep extension reduces pain sensitivity Our results indicate that sleep extension increases pain tolerance beyond baseline levels. However, sleep extension did not impact pain threshold.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3490349/

Sleep Extension in Sleepy Individuals Reduces Pain ... Habitual sleep curtailment appears to be on the rise. Daily sleep time has decreased by 1 hour over the past 40 years. Fifteen percent of respondents in a ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6508947/

Sleep extension reduces fatigue in healthy, normally- ... Sleep extension resulted in reduced fatigue in healthy, normal-sleeping young adults, although subjective sleepiness and mood were not improved.

4. bmcmusculoskeletdisord.biomedcentral.com bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-022-05318-5

The effectiveness of non-pharmacological sleep interventions ... Pain, anxiety and depression were reduced post-treatment, but evidence of longer term benefit was lacking. There was no evidence that sleep ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S1389945723003313

Are physical therapy interventions effective in improving ... Physical therapy achieved an improvement of sleep quality in patients with chronic pain in most of the studies included.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10267346/

Sleep disorders in chronic pain and its neurochemical ... Patients with both CP and sleep disturbances have greater pain severity, longer duration of pain, greater disability, are less physically active ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9272266/

Impact of chronic sleep restriction on sleep continuity ... Chronic sleep restriction (CSR) has been associated with adverse effects including cognitive impairment and increased risk of diabetes and cardiovascular ...

8. academic.oup.com academic.oup.com/sleep/article/35/12/1587/2559050

Sleep Extension in Sleepy Individuals Reduces Pain Sensitivity Although some studies had demonstrated positive effects on pain scores,23 their results are difficult to interpret owing to the complex and confounding effects ...

9. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1087079224000728

Negative health outcomes in long sleepers: The societal ... In fact, findings from sleep extension studies in humans generally suggest only beneficial effects of longer sleep. For example, based on their review of the ...

10. jcsm.aasm.org jcsm.aasm.org/doi/10.5664/jcsm.9476

Sleep is essential to health - Journal of Clinical Sleep Medicine Sleep is a biological necessity, and insufficient sleep and untreated sleep disorders are detrimental for health, well-being, and public safety.