Nonpharmacologic group treatment of insomnia: a preliminary study with cancer survivors

Abstract

This study describes, and examines the initial efficacy of, a sleep therapy programme developed for cancer patients with insomnia. The six-session group programme included stimulus control therapy, relaxation training, and other strategies aimed at consolidating sleep and reducing cognitive-emotional arousal. The 12 final participants were patients of a regional cancer centre; mean age was 54.7 years (S.D. 10.4); median time from cancer diagnosis was 33.6 months; all had high performance status. Participants kept sleep diaries and rated their sleep quality, mood and functioning at baseline, week 4 and week 8. Significant improvement over baseline was observed at weeks 4 and 8 in the number of awakenings, time awake after sleep onset, sleep efficiency, sleep quality ratings, and scores on European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 role functioning and insomnia. Total sleep time and fatigue were significantly improved at week 8. The sleep therapy programme was associated with improved sleep, reduced fatigue and enhanced ability to perform activities in relatively well individuals attending a cancer centre. This is preliminary evidence of the efficacy of the programme. Further research is required to examine the programme's effectiveness and suitability for a wider range of people with cancer. Options for providing cancer patients with access to nonpharmacologic treatments for insomnia are discussed.

Sleep and quality of life in long-term lung cancer survivors

“…They were also associated with increased rates of sedative-hypnotic use. New research showing the potential benefits of cognitive behavioral therapy [44,45] as well as improvements in pharmacotherapy [46,47] may offer increasing effectiveness in treating these patients. Asking lung cancer survivors detailed and concrete questions about their sleep, such as how often they have nocturnal awakenings or how long they are awake each night, is thus a worthwhile and important aspect of their care.…”

Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy

“…Studies also report that poor physical health [27], lower self-efficacy for following the BT sleep intervention plan [28], and lower psychosocial functioning [29] were associated with lower adherence, suggesting that physical symptoms and lack of confidence in abilities may decrease adherence [20]. These factors help explain why 11-33% of cancer patients drop out of individual or group cognitive-behavioral therapy for insomnia [30,31] and may be implicated in adhering to BT treatment targeting generalized sleep disturbance among breast cancer patients.…”

Neuroendocrine-Immune Mechanisms of Behavioral Comorbidities in Patients With Cancer

“…83,133 Indeed, only one controlled study has examined the efficacy of a behavioral intervention for insomnia in cancer patients, 134 with other studies limited by lack of a control group and/or small sample sizes. 135,136 Moreover, no study has included assessments of the impact of these interventions on cortisol rhythms, inflammatory mediators, or behavioral changes.…”