Sleep and Pain in Sickle Cell Disease
Sleep and Pain in Sickle Cell Disease
This is a study testing the effects of behavioral sleep interventions on pain and brain
 function in sickle cell disease.
The investigators propose to examine whether changes in sleep alter pain and pain-related
 outcomes in adults with Sickle Cell Disease (SCD). As many as 70% of adults with SCD
 experience various sleep disturbances. Pain and sleep are inter-related, such that pain
 disturbs sleep and disturbed sleep amplifies pain and increases risk for developing chronic
 pain. Pain processing occurs in the central nervous system, where nociceptive input can be
 inhibited or facilitated and which can undergo both functional and structural plasticity.
 When plasticity results in amplification of pain, this central sensitization (CS) manifests
 as hyperalgesia, allodynia, and spreading of pain and is an important treatment target in its
 own right. A growing literature implicates central sensitization in SCD, and the
 investigators find a strong association between laboratory-evoked CS and sleep disturbance in
 SCD. The neural substrates involved in pain modulation are often disrupted in chronic pain,
 likely due to the demands pain places on cognitive resources, and similar effects are seen
 with chronic insomnia. It remains unclear whether these changes occur in SCD and if improving
 sleep improves central modulation of pain. The potential for improved sleep to reduce pain
 and CS requires additional investigation, particularly given the significance of sleep
 disturbance as a mutable risk factor. The investigators will conduct a randomized trial in
 which it will be determined whether improvements in sleep reduce pain and alter brain
 processing of pain and cognitive stimuli. The aims are to determine whether treatment of
 sleep improves pain outcomes in SCD and to determine whether treatment of sleep alters
 functional connectivity of cognitive and pain modulatory networks using brain imaging in SCD.
Inclusion Criteria:

 -  Diagnosis of sickle cell hemoglobinopathy (Homozygous sickle cell disease, Hemoglobin
 SC disease, or Sickle/beta-thalassemia);

 -  Adequate facility with English;

 -  Stable dosing of medications (if taking) for pain and sleep;

 -  Reports symptoms of insomnia;

 -  Reports chronic pain

 Exclusion Criteria:

 -  Cognitive impairment;

 -  Unstable psychiatric disorder;

 -  Seizure disorder;

 -  Positive pregnancy or drug test