Protocol of a dyadic sleep intervention for adult patients with cancer and their sleep-partner caregivers

Kim, Youngmee; Ting, Amanda; Steel, Jennifer L.; Tsai, Thomas C.

doi:10.1016/j.conctc.2023.101064

Cited by 3 publications

(1 citation statement)

References 47 publications

(66 reference statements)

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“…Moreover, our findings highlight the various psychosocial impacts of cancer in the family (1–3) and suggest the critical need for augmenting our understanding of the efficacy of existing trauma and sleep interventions that simultaneously treat patients with cancer and their caregivers. Dyadic interventions in these areas have been targeted for veterans and their partners (e.g., (98,99)) but remain limited for patients and caregivers affected by medical illnesses, such as cancer (e.g., (100)).…”

Section: Discussionmentioning

confidence: 99%

Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients With Cancer and Their Caregivers

Tsai,

Mitchell,

Zeitzer

et al. 2024

Psychosom Med

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Objective Cancer can be a traumatic experience affecting multidimensional aspects of sleep among patients and caregivers. This study examined the differential associations of cancer-related post-traumatic stress symptoms (PTSS) with various sleep markers in this population. Methods Patients newly diagnosed with colorectal cancer (n = 138, mean age = 56.93 years, 31.88% female, 60.14% Hispanic, 6.53 months post-diagnosis) and their sleep-partner caregivers (n = 138, mean age = 55.32 years, 68.12% female, 57.97% Hispanic) completed questionnaires assessing the four PTSS clusters (intrusion, avoidance, alterations in arousal and reactivity, negative alterations in cognitions and mood). Participants also completed daily sleep diaries for 14 consecutive days, from which sleep onset latency (SOL), wake after sleep onset (WASO), and sleep duration were derived. Results Actor-partner interdependence model revealed that caregivers’ greater alterations in arousal and reactivity were associated with their own longer SOL (b = 14.54, p < .001) and their patients’ longer sleep duration (b = 0.47, p = .040), whereas patients’ arousal and reactivity were associated with their caregivers’ shorter SOL (b = -8.34, p = .047) and WASO (b = -8.12, p = .019). Patients’ and caregivers’ greater negative alterations in cognitions and mood were associated with patients’ longer SOL (b = 8.89, p = .016) and shorter sleep duration (b = -0.40, p = .038), respectively. Caregivers’ greater intrusion was related to their own shorter SOL (b = -10.92, p = .002). Conclusions The four PTSS clusters, particularly arousal and reactivity and negative cognitions and mood, have distinct associations with sleep markers individually and dyadically in patients and caregivers affected by cancer. Investigations of psychosocial and biobehavioral pathways underlying these relations are warranted. Tailored trauma treatments and sleep interventions may improve the well-being of this population.

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Section: Discussionmentioning

confidence: 99%

Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients With Cancer and Their Caregivers

Tsai,

Mitchell,

Zeitzer

et al. 2024

Psychosom Med

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Sleep Composition of Patients With Colorectal Cancer and Their Sleep‐Partner Caregivers: Physical Health Correlates of Sleep Diary and Actigraphy Measurements

Ting,

Tsai,

Zeitzer

et al. 2024

Psycho-Oncology

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BackgroundDisturbed sleep is frequently identified in adult patients with cancer and their caregivers, with detrimental impact on physical health. Less known is the extent to which self‐reported and actigraph‐measured sleep patterns are similar between patients and their sleep‐partner caregivers, and how these different modes of sleep measurements are related to physical health.MethodsPatients diagnosed with colorectal cancer and their sleep‐partner caregivers (81 dyads) completed a questionnaire for physical functioning and collected saliva samples for seven consecutive days, from which cortisol slope was quantified. Additionally, participants completed a daily sleep diary and wore actigraph for 14 consecutive days, from which sleep duration, sleep onset latency (SOL), and duration of wake after sleep onset (WASO) were calculated.ResultsParticipants reported sleep patterns that fell within or close to the optimal range, which were similar between patients and their caregivers. Self‐reported and actigraph‐measured sleep duration had moderate levels of agreement (ICC = 0.604), whereas SOL and WASO had poor agreement (ICC = 0.269). Among patients, longer self‐reported WASO was associated with poorer physical health and flatter cortisol slope (p ≤ 0.013). Among caregivers, longer self‐reported SOL was associated with poorer physical functioning, actigraph‐measured WASO was associated with steeper cortisol slope, and longer self‐reported sleep markers studied than actigraph‐measured were associated with poorer physical functioning (p ≤ 0.042).ConclusionFindings suggest that employing multiple assessment modes for sleep and physical health is vital for comprehensive understanding of sleep health. Furthermore, when addressing patients' sleep health, it may be beneficial to include their sleep‐partner caregivers who may experience similar disturbed sleep.

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Dyadic sleep intervention for adult patients with cancer and their sleep-partner caregivers: A feasibility study

Kim

Ting²,

Tsai

et al. 2023

Pall Supp Care

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Objectives Sleep disturbances are common among adult patients with cancer and their caregivers. To our knowledge, no sleep intervention to date has been designed to be provided to both patients with cancer and their caregivers simultaneously. This single-arm study aimed to pilot test the feasibility and acceptability, and to illustrate the preliminary efficacy on sleep efficiency of the newly developed dyadic sleep intervention, My Sleep Our Sleep (MSOS: NCT04712604). Methods Adult patients who were newly diagnosed with a gastrointestinal (GI) cancer and their sleep-partner caregivers (n = 20 persons: 10 dyads, 64 years old, 60% female patients, 20% Hispanic, 28 years relationship duration), both of whom had at least mild levels of sleep disturbance (Pittsburgh Sleep Quality Index [PSQI] ≥ 5) participated in this study. MSOS intervention consists of four 1-hour weekly sessions delivered using Zoom to the patient–caregiver dyad together. Results We were able to enroll 92.9% of the eligible and screened patient–caregiver dyads within 4 months. Participants reported high satisfaction in 8 domains (average 4.76 on a 1–5 rating). All participants agreed that the number of sessions, interval (weekly), and delivery mode (Zoom) were optimal. Participants also preferred attending the intervention with their partners. Both patients and caregivers showed improvement in sleep efficiency after completing the MSOS intervention: Cohen’s d = 1.04 and 1.47, respectively. Significance of results Results support the feasibility and acceptability, as well as provide the preliminary efficacy of MSOS for adult patients with GI cancer and their sleep-partner caregivers. Findings suggest the need for more rigorous controlled trial designs for further efficacy testing of MSOS intervention.

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Protocol of a dyadic sleep intervention for adult patients with cancer and their sleep-partner caregivers

Cited by 3 publications

References 47 publications

Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients With Cancer and Their Caregivers

Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients With Cancer and Their Caregivers

Sleep Composition of Patients With Colorectal Cancer and Their Sleep‐Partner Caregivers: Physical Health Correlates of Sleep Diary and Actigraphy Measurements

Dyadic sleep intervention for adult patients with cancer and their sleep-partner caregivers: A feasibility study

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