Optimization of the Care Pathway for Patients With Chronic Pain: Assessing the Value of Integrating Sleep Specialists

Inclusion Criteria:

• First consultation at the pain management center

• Patient with chronic pain as defined by the "Haute Autorité de Santé". The pain musthave several of the following characteristics:

• Persistence or recurrence

• Duration beyond what is usual for the presumed initial cause, especially if thepain has been evolving for more than 3 months;

• Inadequate response to treatment;

• Important and progressive deterioration of the patient's functional andinterpersonal abilities in activities of daily living at home, school, or workdue to the pain.

• Patients with chronic primary pain (according to the typology defined by theInternational Classification of Diseases-11) and classified into one of the 4following categories:

• Chronic generalized pain

• Complex regional pain syndrome

• Chronic primary headache or orofacial pain

• Chronic primary musculoskeletal pain

• Pittsburgh Sleep Quality Index (PSQI) must be completed by the patient and the scoremust be available (for randomization purposes)

• Have access to an internet connection as a self-administered questionnaire is tocomplete online, and at least have access to the online platform for CBT treatmentif insomnia is detected

• Affiliation to a French social security system

• Free informed consent

Exclusion Criteria:

• Patients undergoing cancer treatment or who have completed treatment within the last 2 years

• Patient with a chronic inflammatory disease (e.g. rheumatoid arthritis, ankylosingspondylitis, chronic inflammatory bowel disease, Horton's disease, Wegener'sdisease, myositis, Still's disease, lupus erythematosus, etc.)

• Immunocompromised patient

• Patient with severe psychiatric pathology that does not allow study follow-up (atthe discretion of the investigator)

• Patient already treated for a sleep disorder by a sleep specialist (the onlyprescription of hypnotics is not considered as a criterion of non-inclusion)

• Patient follow-up difficult (for geographic motives or other reasons)

• Patient under judicial protection of incapable adults or guardianship

• Refusal to participate in the research