The investigators' primary goal is to assess the extent to which three forms of cognitive-behavioral treatment (CBT for insomnia, CBT for pain, and combined insomnia & pain) diminishes insomnia symptoms in patients with chronic pain compared to a group not receiving CBT. This will be evaluated in a randomized trial with before and after evaluations using standard sleep diary measures of sleep continuity. The investigators' secondary goal is to assess whether treatment responses to any of the interventions are associated with alterations in immune function. The investigators' tertiary goals are to evaluate whether improved sleep has effects on patient reports of pain severity, frequency, and tolerability as well as on mood and quality of life.
Inclusion Criteria: - Ages 35-75 - Chronic non-malignant painful condition of the spine of > 6 months duration - Insomnia (> 30 minutes sleep latency and/or wake after sleep onset time for > 3 days/week for > 6 months) - Insomnia developed after the onset of the painful condition - Preferred sleep phase between 10:00 p.m. and 8:00 am - On stable medical regimen for medical and pain conditions (no surgery planned) - Willingness to discontinue hypnotic medications Exclusion Criteria: - Unstable medical or psychiatric illness - History of seizures - Evidence of active illicit substance use or fitting criteria for ethanol (ETOH) abuse or dependence - Symptoms suggestive of sleep disorders other than insomnia - Polysomnographic data indicating sleep disorders other than insomnia - Inadequate language comprehension - Fibromyalgia - Pregnancy