# Efficacy of Scalable CBT for Insomnia in Older Adults with Osteoarthritis Pain

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $472,986

## Abstract

Twenty-five percent of older adults experience significant osteoarthritis (OA)-related comorbid
sleep disturbance. Insomnia is associated with substantial negative effects on function, mood,
and medical resource utilization. Cognitive behavioral therapy for insomnia (CBT-I) is evidence-
based and has been shown to be efficacious in populations with a variety of comorbid
conditions including OA-related chronic pain. However, in-person CBT interventions are unlikely
to be widely deployable in healthcare systems. Telephone delivery has the advantage of giving
patients access to personalized, efficacious CBT-I interventions from home, increasing
generalizability, and outreach to minority, rural, and other underserved populations. Previous
small trials of telephone CBT-I have reported positive insomnia outcomes, but no large
randomized trials have assessed its long-term efficacy, impact on related outcomes in a primary
care patient population, or cost-effectiveness. This proposal builds upon our successful
completion of two randomized trials of CBT for insomnia with older adults: Lifestyles, a trial of
group CBT in older adults with OA-related insomnia and pain, and MsFLASH04, a trial of
telephone CBT-I for insomnia in menopausal women with comorbid vasomotor symptoms. Older
(60+ yrs) primary care patients across Washington State will be screened for severe persistent
OA-related insomnia and pain. Two hundred and seventy patients will be randomized to either
CBT-I or an education only attention control (EOC). Each treatment will consist of six 20-30
minute telephone-based sessions over an eight week period. Pre-treatment, post-treatment (2
months), and 9 and 18 month assessments will include measures of sleep, pain, fatigue, mood,
and quality of life. A cost effectiveness evaluation of the intervention will also be conducted. We
hypothesize: 1) CBT-I will produce significantly greater initial and long-term improvements in
sleep outcomes relative to EOC; 2) CBT-I will produce significantly greater initial and long-term
improvements in pain, fatigue and mood relative to EOC; and 3) CBT-I will produce long-term
reductions in health care utilization and costs relative to EOC. We will also explore whether
changes in insomnia severity explain observed effects of CBT-I on secondary outcomes
(mediator analysis), and whether CBT-I effects on insomnia differ by baseline insomnia, pain, or
depression symptom severity (moderator analysis). The proposed research will determine if
telephone CBT-I improves OA insomnia and associated outcomes in a state-wide primary care
population of older adults, and inform policy decisions about widespread dissemination of
telephone CBT-I in this and related patient populations.

## Key facts

- **NIH application ID:** 9924422
- **Project number:** 5R01AG053221-05
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** SUSAN M MCCURRY
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $472,986
- **Award type:** 5
- **Project period:** 2016-09-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9924422

## Citation

> US National Institutes of Health, RePORTER application 9924422, Efficacy of Scalable CBT for Insomnia in Older Adults with Osteoarthritis Pain (5R01AG053221-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9924422. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*