Presleep cognitions in patients with insomnia secondary to chronic pain

This study had two primary objectives: (I) characterize the content of pres leep cognitions of chronic pain patients and (2) evaluate the association b etween presleep cognitions and sleep disturbance. Thirty-one outpatients wi th benign chronic pain completed the Beck Depression Inventory, pain and sl eep diaries and participated in an in vivo, presleep thought sampling proce dure for I week in their homes. The three most frequently reported presleep cognitions were general pain-related thoughts (36%), thoughts about the ex perimental procedure (27%), and negative sleep-related thoughts (26%), Step wise multiple regression analyses found that presleep thoughts pertaining t o pain and environmental stimuli were significantly associated with sleep c ontinuity, independent from the effects of depression and nightly pain seve rity. Pain severity was found to be positively associated with Wake After S leep Onset Time. These results are consistent with cognitive-behavioral mod els of primary insomnia and suggest the content of presleep cognitive arous al may contribute to sleep disturbance secondary to pain.