A Pilot Study of Audio-Visual Stimulation as a Self-Care Treatment for Insomnia in Adults with Insomnia and Chronic Pain

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School of Nursing Departmental Papers
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Acoustic Stimulation
Adult
Chronic Pain
Comorbidity
Female
Humans
Male
Middle Aged
Photic Stimulation
Pilot Projects
Self Care
Severity of Illness Index
Sleep Initiation and Maintenance Disorders
Treatment Outcome
Acoustic Stimulation
Adult
Chronic Pain
Comorbidity
Female
Humans
Male
Middle Aged
Photic Stimulation
Pilot Projects
Self Care
Severity of Illness Index
Sleep Initiation and Maintenance Disorders
Treatment Outcome
Health Information Technology
Medical Humanities
Medicine and Health Sciences
Nursing
Sleep Medicine
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Tang, Hsin-Yi
Vitiello, Michael V
Perlis, Michael
Mao, Jun James
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Abstract

This pilot study tested the efficacy of an audio-visual stimulation (AVS) program for the promotion of sleep in individuals with chronic pain. Insomnia and chronic pain are common comorbid conditions and their relationship has been viewed as bidirectional. Recent studies suggest a relatively dominant role of sleep in this dyad. The premise of this pilot study was that AVS enhances low frequency while reducing high frequency brain activity resulting in decreased hyperarousal and improved sleep with potential consequent reduction in pain. We conducted a pilot intervention study of AVS using a pre-post design. Participants self-administered a 30-min AVS program nightly at bedtime for 1 month. Sleep and pain were assessed at baseline and at the conclusion of the 4-week intervention phase. Nine adults (mean age 33 ± 15.8 years; female, 89 %) completed the study. After using the AVS device for 4 weeks, significant improvement was seen in reported insomnia (ISI, p = 0.003), pain severity (BPI, p = 0.005), and pain interference with functioning (BPI, p = 0.001). Large effect sizes (Partial η2 0.20-0.94) (Cohen's d 0.44-1.45) were observed. The results of this pilot study suggest that the AVS program may be efficacious in decreasing both insomnia and pain symptoms. In order to better assess the efficacy of AVS for sleep promotion and possible pain reduction, more definitive randomized controlled trials will be needed. These should include appropriate sample sizes, objective measures of sleep and pain, and longitudinal follow-up.

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2014-12-01
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Applied Psychophysiology and Biofeedback
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