| Within the coming decades, the projected increase in the number of older adults will be accompanied by an increase in age-related health care issues. Chronic pain and insomnia are two common health conditions that compromise quality of life and successful aging. Although pharmacotherapy is commonly prescribed for these conditions, myriad problems associated with pharmacotherapy suggest the need for more benevolent treatments. This quantitative, quasi-experimental study evaluated the efficacy of a 21-day hypnotic protocol for the treatment of comorbid chronic pain and insomnia in 26 community-dwelling adults aged 60 years and older. A within-subjects repeated measures, treatment-only design was used. One-way repeated measures ANOVAs were conducted to assess pre- and posttreatment differences for pain intensity, pain severity, severity of insomnia, sleep onset latency, frequency of awakenings, quality of sleep, and quality of life. Significant treatment effects (p < .05), with large effect sizes (ranging from .22 to .41), were found for all variables except sleep onset latency. Hypnotizability, as measured by the Long Stanford Scale, did not affect treatment outcome. The majority of the participants (81%) perceived some improvement; however, the mean overall impression of change was not equal to clinically important improvement. The findings also supported the existence of a bidirectional relationship between pain and sleep. A significant negative correlation was found between pain intensity and quality of sleep (r = .30, p < .001). The results of Wilcoxon signed ranks tests suggested that (a) hypnotic suggestions for hypnoanalgesia significantly improved quality of sleep (p = .036) and (b) hypnotic suggestions for improved sleep significantly decreased pain intensity (p = .026); effect sizes were r = .25 and r = .26, respectively. Based on one-month follow-up data (n = 22), 86% of the respondents continued to listen to the hypnotic CDs postintervention. Improvements were maintained for each of the variables assessed at one-month follow-up: pain severity, severity of insomnia, and quality of life. The overall findings suggest that hypnosis may be efficacious for the treatment of comorbid pain and insomnia in older adults. Future research should utilize heterogeneous research methods and analysis of synthesized results in a Pragmatic Systematically Conducted Review. |
