Projects
Current Projects
This study aims to investigate the feasibility of a modified version of Cognitive Behavioral Therapy for Insomnia (CBT-I; the recommended first-line treatment for insomnia) that considers the relationship between sleep and pain. This is important because both insomnia and chronic pain are widespread and significantly impact global health, incurring high societal costs. Despite their prevalence, clinical practices currently do little to address sleep issues in the management of chronic pain, often resorting to medication without directly targeting sleep problems.
This research project is supported by the EUTOPIA Science and Innovation Fellowship Programme and funded by the European Union Horizon 2020 programme under the Marie Skłodowska-Curie grant agreement No 945380.
Recruitment is ongoing for this study. Click here Link opens in a new windowto register!
Example Past Projects
Warwick Study of Mental Defeat in Chronic Pain (WITHIN)
Mental defeat is defined as the perceived loss of autonomy in the face of uncontrollable, traumatic events. Applied to the context of chronic pain this can be explained as a loss of identity and self in relation to repeated episodes of pain. This study follows on from previous work to apply an experimental, lab-based study to patients with chronic pain (previously done in pain-free, young adults). Additionally, a longitudinal sleep-tracking survey spanning across a 12-month period will collect data on how day-to-day lived experiences of pain impact health & quality of life.
Funder: Medical Research Council (MRC)Link opens in a new window
Warwick RECOVERS Study - Responding to COVID by Enhancing Resilience in Students
COVID-19 has presented varying levels of stress and uncertainty to society worldwide. The economic, social and psychological impact of the social distancing measures have added to the growing challenge of maintaining positive mental health and wellbeing. Previous research on the consequences of SARS epidemic in China has shown a significant and long-lasting psychosocial impact of the crisis (Mak et al., 2009). Within Warwick, discussions with subgroups of students staying on campus amid university closure have revealed a high level of anxiety and unease. It is unclear whether the levels of stress and uncertainty they experience is comparable to those normally associated with trauma, i.e., whether it can negatively affect important pillars of health (e.g., mood, sleep, physical activity), and whether it may aggravate psychiatric symptoms or extreme behaviour that warrant clinical attention. RECOVERS is a university-wide mental health screening and tracking study to try and answer these questions.Funder: University of Warwick PVC (Research) COVID-19 Research Programme AwardLink opens in a new window
Chronic pain is often co-morbid with insomnia which can lessen people's ability to effectively deal with their pain and even exacerbate the pain itself. Current treatments however tend to focus solely on treating the pain, little help is available to treat insomnia apart from medications which show little evidence of being effective in the long-term. The current study therefore aims to trial, in a primary care setting, a new intervention designed to treat pain and sleep problems concurrently using a hybrid Cognitive-Behavioural approach.
Funder: National Institute for Health ResearchLink opens in a new window
The Effect of Mental Defeat on Pain Threshold, Pain Anticipation and Pain Ratings: An Experimental Study with Pain-Free, Young Adults.
Mental defeat is defined as the perceived loss of au-tonomy in the face of uncontrollable, traumatic events. Applied to the context of chronic pain this can be explained as a loss of identity and self in relation to repeat-ed episodes of pain.
Funder: URSS Link opens in a new window(awarded to Natasha Kwol and Sarina Afzalishamsabad)
Sleep and Daytime Physical Activity in People with Chronic Pain
People with chronic pain are reported to be physically less active than those without chronic pain in the general population. Numerous psychological factors have been associated with their relatively lower physical activity levels. The current study therefore aims (i) to investigate the effects of day-to-day variations in sleep quality on daytime physical activity in mixed chronic pain groups (e.g. fibromyalgia, back pain, arthritis, neck & shoulder pain etc); (ii) to investigate whether increase in daytime physical activity level will have an effect on pain regulation; (iii) to examine the daily psychophysiological variables (e.g. pain, mood, tiredness) that may interact with sleep to impact the regulation of daytime physical activity.
Funder: Ministry of Higher Education, MalaysiaLink opens in a new window (PhD Scholarship awarded to Fatanah)
Effects of sleep changes on pain-related health outcomes in the general population: A systematic review of longitudinal studies with exploratory meta-analysis.
Emerging longitudinal research has highlighted poor sleep as a risk factor of a range of adverse health outcomes, including disabling pain conditions. In establishing the causal role of sleep in pain, it remains to be clarified whether sleep deterioration over time is a driver of pain onset and, importantly, whether sleep improvement over time can prevent or mitigate pain related outcomes.
A systematic literature search was performed using PubMed MEDLINE, Ovid EMBASE, and Proquest PsycINFO, to identify 16 longitudinal studies that evaluated the effect of sleep changes (simulating sleep deterioration, sleep stability or sleep improvement over time) on subsequent pain related outcomes in the general population.
Investigating the Embodied Representation of Mental Defeat
Gestures can depict abstract concepts (for example, defeat) through metaphorical use of space and body. In fact, victory triggers upward body movements even in congenitally blind athletes. This suggests that the direction and location of gestures may be an important part of gestural representation of defeat. The aim of this study was to investigate embodied representations of mental defeat through the observation of how gestures depict defeat experiences
Funder: Experimental Psychology Society (to Professor Sotaro Kita)
Development of the Pain-Related Beliefs and Attitudes about Sleep (PBAS) scale for the assessment and treatment of insomnia comorbid with chronic pain.
Maladaptive beliefs about the sleep-pain interaction are possible factors underlying perpetuation of sleep disturbances in chronic pain-related insomnia. However, there is currently no validated instrument that specifically assesses these beliefs.
We evaluated the psychometric and functional properties of a 10-item Pain-Related Beliefs and Attitudes about Sleep (PBAS) scale, designed to assess pain-related dysfunctional beliefs and attitudes about sleep among people with chronic pain.
Understanding people's definition of sleep quality in good and poor sleepers: A quantitative approach using the Markov Chain Monte Carlo with people method
The judgment of sleep quality is subjective and varies between people. This experimental study is designed to quantitatively investigate the structural parameters of sleep quality using Markov Chain Monte Carlo with people method.
Funder: Ministry of Education, MalaysiaLink opens in a new window (PhD Scholarship awarded to Fatanah)
Pain inhibitory processes and sleep disruptions in healthy young adults.
Diffuse Noxious Inhibitory Control (DNIC) response/Conditioned Pain Modulation (CPM) is a clinical marker of impaired pain inhibitory processes in a range of chronic pain conditions. This study explored reliability and differences between two conditioning stimulus used to elicit DNIC responses and the influence of subjective poor sleep and sleep disruptions on DNIC responses.
Funder: University of Warwick Postgraduate Research FellowshipLink opens in a new window (PhD scholarship awarded to Esther)
Nonpharmacological Treatments of Insomnia for Long-Term Painful Conditions: A Systematic Review and Meta-analysis of Patient-Reported Outcomes in Randomized Controlled Trials.
Insomnia is a debilitating comorbidity of chronic pain. This study evaluated the effect of nonpharmacological sleep treatments on patient-reported sleep quality, pain, and well-being in people with long-term cancer and non-cancer (e.g., back pain, arthritis, fibromyalgia) pain conditions.
Funder: Warwick Research Development FundLink opens in a new window
Sleep in patients with primary dystonia: A systematic review on the state of research and perspectives
Primary dystonia is the third most prevalent neurological movement disorder after essential tremor and Parkinson’s disease. It is characterised by involuntary muscle contractions accompanied by repetitive movement, abnormal posture and pain.
Non-motor symptoms of primary dystonia, including sleep disturbance, negatively impact on quality of life1. Given the increasingly evident link between pain and sleep and the emerging trend of hybrid intervention to tackle both issues simultaneously2, we systematically reviewed the state of research on sleep in primary dystonia
Funder: Dystonia SocietyLink opens in a new window and a European Sleep Research Society Travel Grant for Early Career Researcher (awarded to Elisabeth Hertenstein)
Exploring the essential ingredients of a good night's sleep: A qualitative study with people with fibromyalgia, back pain, and healthy individuals without chronic pain
A good night's sleep is a rare luxury for many people with chronic pain. This qualitative study explored the parameters of subjective sleep quality in people with fibromyalgia, those with back pain and healthy individuals without chronic pain. A second objective was to identify the possible pathways through which appraisals of sleep quality might impact on subsequent engagement in physical and social activity.
Funder: Ministry of Education, MalaysiaLink opens in a new window (PhD Scholarship awarded to Fatanah)
Better sleep quality promotes next-day physical activity in chronic pain patients
Promoting physical activity is key to the management of chronic pain, but little is understood about the factors facilitating an individual’s engagement in physical activity on a day-to-day basis. This study examined the within-person effect of sleep on next day physical activity in patients with chronic pain and insomnia.
Funder : National Institute for Health Research, UKLink opens in a new window
The role of pain, physical disability and reduced social participation in insomnia onset in community dwelling older adults: A prospective cohort study
Most patients with chronic pain have insomnia that warrants clinical attention. This study examined the role of pain, physical disability, and reduced social participation in predicting and mediating insomnia onset in community dwelling older adults. Theories of pain-related insomnia identify activity dysregulation as a behavioural mechanism augmenting sleep disturbance. Participation in social and physical activities was hypothesised to be sleep promoting because engagement in activities generates sleep pressure and brings the exposure to light and stimulation that entrain the circadian rhythm.
Funder: The Medical Research Council, UKLink opens in a new window