A Self-Administered Sleep Intervention for Patients With Cancer Experiencing Insomnia

Abstract

Adherence to the sleep intervention was high (75%), and significant improvement was found in global sleep quality (p < 0.0001) regardless of level of adherence. Sleep onset latency (p = 0.0005), sleep duration (p = 0.0016), and sleep quality (p < 0.0001) were significantly improved. Age was significantly correlated with sleep quality (p = 0.0094), with older participants reporting greater benefit from the intervention. Participants reported that the intervention was easy to learn and implement and that it "calmed the mind."

Adherence to Cognitive Behavior Therapy for Insomnia

“…Younger age was identified as a predictor of wake time variability in one study 40 , but not in another 10 ; older age was a predictor of bedtime and rise time variability 62 , although another study did not find a significant relationship between age and adherence 48 . Post-secondary education and employment status was not related to self-reported adherence 16,40 . Having a bed partner or pet was positively related to adherence to stimulus control 30 .…”

“…There were conflicting findings regarding subjective adherence measures. While some found that self-reported 16,44 adherence was not related to treatment outcomes, in two studies self-reported frequency of using treatment components was significantly related to lower ISI scores post-treatment, for overall CBT-I use (r=0.53 20 ) and adherence specifically for cognitive (r =−0.34 58 ) and behavioural components (r=−0.27 58 ).…”

“…Overall, the majority of studies recruited mainly female participants. In sixteen studies individuals with insomnia and a comorbid condition were recruited; in eight the comorbid condition was cancer [9][10][11][12][16][17][18][19] . Other comorbidities included depression 20 , bipolar disorder 21 , alcohol dependency 13 , cardiac rehabilitation 22 , war veterans with blast exposure/head injury 23 , HIV 24 , chronic migraine 25 and COPD 26 .…”

“…The majority of studies defined presence of insomnia by using diagnostic criteria (e.g., DSM-IV 27 , ICSD 28 , or research diagnostic criteria 29 ). Screening questionnaires included the Insomnia Severity Index 11,[30][31][32] , or the Pittsburgh Sleep Quality Index 9,16,26 . A number of studies set a minimum SOL and WASO score 12,18,[33][34][35] in addition to daytime dysfunction/impairment 21,23,24,[36][37][38][39][40][41][42][43] .…”

“…There was a variety of combinations of treatment components. Two studies focused on progressive muscle relaxation 26,45 , or focused on breathing and visualisation 16 . Several studies evaluated cognitive and behavioural CBT-I components separately and as a combined intervention 42,46 .…”