A phone-delivered therapy program relieved insomnia and helped reduce fatigue and pain tied to osteoarthritis, according to a study from Kaiser Permanente Washington.

The Osteoarthritis and Therapy for Sleep, or OATS, study followed the progress of 327 people aged 60 years and older with osteoarthritis and moderate to severe insomnia for two years. Therapy consisted of guided training and education in cognitive behavioral therapy for insomnia, or CBT-I. Phone interviews were conducted six times for about 30 minutes over eight weeks. A control group received education-only phone calls, but not the therapy.

At a 12-month check-in, fully 56% of participants who received CBT-I were still in remission from insomnia, compared with 26% of participants in the education-only control group.

“It’s very exciting,” said lead author Susan M. McCurry, Ph.D., of the University of Washington School of Nursing. “[W]hen people have insomnia, it’s miserable. Our study has shown that this treatment can be delivered over the phone, and its effects are sustainable for up to a year.”

CBT-I is a proven and effective first-line strategy for treatment for insomnia, the researchers said. Therapists guided patients through routines, information and self-monitoring to get their internal sleep drive (homeostatic sleep drive) and innate physiological sleep cycles (circadian sleep rhythms) working together. When successful, therapy patients will relearn to sleep at night and be wakeful during the daytime, the authors said. 

“The bottom line is nobody should be sleeping poorly,” said Michael Vitiello, co-author and professor of psychiatry and behavioral sciences at the UW School of Medicine. “We have ways to fix sleep problems. Older adults don’t need to suffer. We can make them better.”

The study was published in JAMA Internal Medicine.

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Empathy-oriented phone call intervention improves mental health in seniors  Empathetic listening in phone calls to homebound seniors rapidly reduced the seniors’ loneliness, depression and anxiety. The intervention, provided by trained laypersons and designed to be a continual support program, may be a useful solution to the persistent mental health challenges of older adults, investigators wrote in JAMA Psychiatry.