The Effectiveness of Acceptance and Commitment Therapy, Transcranial Direct Current Stimulation, and Pharmacotherapy on The Sleep Quality of Women with Chronic Pain: A Randomized Clinical Trial

Abstract

Background: Sleep quality is a major factor affecting physical and mental health. Poor sleep quality is a common complaint in many psychiatric disorders. Objectives: The present study aimed to investigate the effectiveness of acceptance and commitment therapy (ACT), transcranial direct current stimulation (tDCS), and pharmacotherapy on the sleep quality of women with chronic pain in Tehran, Iran. Methods: This randomized clinical trial with a pre-test, post-test, and follow-up design and a control group was performed on the statistical population of all women with chronic pain visiting Pardis Pain Clinic, Tehran, Iran, in 2020. The sample consisted of 60 women with chronic pain. We randomly divided the participants into four groups ACT, pharmacotherapy, tDCS, and control (N = 15 per group). The research instrument was the Pittsburgh sleep quality index (PSQI). The data were analyzed using repeated measures analysis of variance by the SPSS software. Results: The participants aged 46.67 ± 8.39, 48.24 ± 7.54, 47.67 ± 7.42, and 47.39 ± 6.85 years in the ACT, pharmacotherapy, tDCS, and control groups, respectively. ACT (F = 7.76, P < 0.001), pharmacotherapy (F = 17.97, P < 0.001), and tDCS (F = 9.37, P < 0.001) significantly improved the sleep quality of patients with chronic pain compared to the control group. The effects of ACT, pharmacotherapy, and tDCS on the sleep quality of women with chronic pain did not significantly differ (P > 0.05). Conclusions: ACT and tDCS intervention programs effectively improved the sleep quality of patients with chronic pain. Therefore, ACT and tDCS are recommended to enhance sleep quality in chronic pain patients.