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Hybrid Cognitive‐Behavioral Therapy Intervention for Adolescents With Co‐Occurring Migraine and Insomnia: A Single‐Arm Pilot Trial
Author(s) -
Law Emily F.,
Wan Tham See,
Aaron Rachel V.,
Dudeney Joanne,
Palermo Tonya M.
Publication year - 2018
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.13355
Subject(s) - insomnia , medicine , migraine , cognitive behavioral therapy for insomnia , cognitive behavioral therapy , physical therapy , sleep hygiene , primary insomnia , sleep onset latency , intervention (counseling) , cognition , clinical psychology , sleep disorder , psychiatry , sleep quality
Objective This study aimed to evaluate feasibility and acceptability of a hybrid cognitive‐behavioral therapy intervention for adolescents with co‐occurring migraine and insomnia. Background Many youth with chronic migraine have co‐occurring insomnia. Little research has been conducted to evaluate behavioral treatments for insomnia in youth with migraine. Design and Methods We conducted a single‐arm pilot trial to evaluate the feasibility and acceptability of delivering cognitive‐behavioral therapy for insomnia to 21 youth (mean age 15.5, standard deviation 1.6) with co‐occurring chronic migraine and insomnia. Adolescents completed up to 6 individual treatment sessions over 6 to 12 weeks, and 1 booster session 1 month later. Assessments included a prospective 7‐day headache and sleep diary, and self‐report measures of insomnia, sleep quality, sleep habits, and activity limitations at pre‐treatment, immediate post‐treatment, and 3‐month follow‐up. Results Adolescents demonstrated good treatment adherence and families rated the intervention as highly acceptable. Preliminary analyses indicated improvements from pre‐treatment to post‐treatment in primary outcomes of headache days ( M = 4.7, SD = 2.1 vs M = 2.8, SD = 2.7) and insomnia symptoms ( M = 16.9, SD = 5.2 vs M = 9.5, SD = 6.2), which were maintained at 3‐month follow‐up ( M = 2.7, SD = 2.8; M = 9.3, SD = 5.0, respectively). We also found improvements in secondary outcomes of pain‐related activity limitations as well as sleep quality, sleep hygiene, and sleep patterns. Conclusions These preliminary data indicate that hybrid cognitive‐behavioral therapy is feasible and acceptable for youth with co‐occurring chronic migraine and insomnia. Future randomized controlled trials are needed to test treatment efficacy on migraine, sleep, and functional outcomes. ClinicalTrials.gov Identifier: NCT03137147.