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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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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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Acknowledgments

This project was conducted with the support of (1) John A. Hartford Foundation Claire M. Fagin Fellowship—National Hartford Center of Gerontological Nursing Excellence, (2) National Institute of Nursing Research T-32 Post-doctoral fellowship (NINR 5-T32-NR009356) from the NewCourtland Center for Transitions and Health, School of Nursing University of Pennsylvania, (3) the pilot study fund from the Biobehavioral Research Center, School of Nursing University of Pennsylvania, (4) the Sinegal Faculty Development Fund, College of Nursing, Seattle University, and (5) Center for Research on the Management of Sleep Disturbances (P30 NR011400), University of Washington. Special thanks to Akiko Miller, Yip-Han Lee, Taylor Goulding, Cara Mcguinness, and Regina Belche for their exceptional assistance and contribution on the project.

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Authors and Affiliations

  1. Health Science Center, School of Nursing, University of Washington, 1959 NE Pacific St., Box 357263, Seattle, WA, 98195-7263, USA

    Hsin-Yi Tang

  2. Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, 98195, USA

    Michael V. Vitiello

  3. School of Medicine, University of Pennsylvania, Philadelphia, PA, 19106, USA

    Michael Perlis & Jun James Mao

  4. School of Nursing, University of Pennsylvania, Philadelphia, PA, 19106, USA

    Barbara Riegel

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  1. Hsin-Yi Tang
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  2. Michael V. Vitiello
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Correspondence to Hsin-Yi Tang.

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Tang, HY., Vitiello, M.V., Perlis, M. et al. A Pilot Study of Audio–Visual Stimulation as a Self-Care Treatment for Insomnia in Adults with Insomnia and Chronic Pain. Appl Psychophysiol Biofeedback 39, 219–225 (2014). https://doi.org/10.1007/s10484-014-9263-8

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