title: A pilot study of audio-visual stimulation as a self-care treatment for insomnia in adults with insomnia and chronic pain.
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 η(2) 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.
authors.affiliation: Health Science Center, School of Nursing, University of Washington, 1959 NE Pacific St., Box 357263, Seattle, WA, 98195-7263, USA, jeantang@uw.edu.
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Tang
authors.forename: Michael V
authors.initials: MV
authors.lastname: Vitiello
authors.forename: Michael
authors.initials: M
authors.lastname: Perlis
authors.forename: Jun James
authors.initials: JJ
authors.lastname: Mao
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods*; D000328:Adult; D059350:Chronic Pain / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation / Q000379:methods*; D010865:Pilot Projects; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome