Randomized Trial of a Cognitive-Behavioral Intervention for Insomnia in Breast Cancer Survivors

Epstein, Dana R.; Dirksen, Shannon Ruff

doi:10.1188/07.onf.e51-e59

Cited by 134 publications

(121 citation statements)

References 42 publications

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“…They reported difficulty sleeping and that a lack of exercise, dietary problems, and air pollution contributed to their breast cancer. All of these observations are supported by numerous studies (Stewart et al, 2001;Anderson et al, 2003;Carpenter et al, 2004;Dirksen & Epstein, 2007;Wang et al ., 2010;Ferrucci et al, 2011;Panjari et al, 2011). Causal attributions may impact cancer survivors' quality of life (Stewart et al, 2001;Ferrucci et al, 2011).…”

Section: Discussionsupporting

confidence: 76%

“…Cancer patients frequently experience insomnia. Cancer patients generally have difficulty sleeping (Epstein & Dirksen, 2007). Between 30% and 73% of cancer patients experience difficulty sleeping (Anderson et al, 2003).…”

Section: Relationships Between Cause Of Cancer and Breast Cancerrelatmentioning

confidence: 99%

“…Between 30% and 73% of cancer patients experience difficulty sleeping (Anderson et al, 2003). Specifically, breast cancer survivors are most likely to experience sleep disorders (Carpenter et al, 2004;Epstein & Dirksen, 2007). Causal attributions may impact cancer survivors' quality of life, and psychosocial adjustment (Stewart et al, 2001;Ferrucci et al, 2011).…”

Section: Relationships Between Cause Of Cancer and Breast Cancerrelatmentioning

confidence: 99%

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Relationships Between Cause of Cancer and Breast Cancer-Related Factors in Breast Cancer Survivors

Wang¹,

Chung²

2012

Asian Pacific Journal of Cancer Prevention

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Aims: The purposes of this study were to (1) to identify the causes of cancer in breast cancer survivors in Taiwan; and (2) to investigate the influence of demographic characteristics and breast cancer-related factors on the cause of cancer. Materials and Method: This study details the related investigative results on survivors with breast cancer using a descriptive and correlational design. A convenience sampling approach was employed. A structured questionnaire was used to assess the participants. Results: A total of 230 breast cancer survivors completed the questionnaire. Low-scoring cause of cancer participants were older adults (OR = 2.49, p<0.05) who were already of menopausal status (OR = 2.28, p < 0.05). Around 72% of particpants agreed high responsibility. Our breast cancer survivors felt stress had caused their breast cancer. Conclusions: These findings are helpful in understanding the relationship between cause of cancer and related factors in breast cancer survivors.

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Section: Discussionsupporting

confidence: 76%

Section: Relationships Between Cause Of Cancer and Breast Cancerrelatmentioning

confidence: 99%

Section: Relationships Between Cause Of Cancer and Breast Cancerrelatmentioning

confidence: 99%

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Relationships Between Cause of Cancer and Breast Cancer-Related Factors in Breast Cancer Survivors

Wang¹,

Chung²

2012

Asian Pacific Journal of Cancer Prevention

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“…Sleep hygiene recommendations include caffeine and exercise avoidance near bedtime, comfortable sleep surroundings (dark, cool, peaceful, and relaxing), and soothing activities at bedtime (reading, tranquil music). Several studies have demonstrated the benefit of behavioral therapies for sleep improvement and fatigue in long-term cancer survivors [31][32][33] . In addition, behavioral therapies may often be combined with complimentary therapies to address sleep issues.…”

Section: Sleep Therapymentioning

confidence: 99%

Cancer-Related Fatigue: The Approach and Treatment

Escalante

Manzullo

2009

J GEN INTERN MED

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“…CBT-I has welldocumented benefits, including improvements in insomnia, sleep continuity, and daytime symptoms among patients with a number of comorbid medical conditions. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] CBT-I also may improve sleep for HF patients who dislike the adverse effects of hypnotic medications 12 and are at especially high risk for insomnia and disabling daytime symptoms 34 that are often attributed to HF itself. However, the effects of CBT-I in HF patient have not been examined, and it is not clear that the results of previous studies of CBT-I in people with other chronic medical conditions are generalizable to the HF population.…”

mentioning

confidence: 99%

Feasibility and Efficacy of a Self-Management Intervention for Insomnia in Stable Heart Failure

Redeker

Jeon

Andrews

et al. 2015

Journal of Clinical Sleep Medicine

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Background: Chronic insomnia is common among patients with heart failure (HF) and may contribute to fatigue and poor function. However, to date there have been no randomized controlled trials focused on treatment of insomnia or daytime symptoms in this population. Objective: The purpose of this study was to examine the preliminary effi cacy, feasibility, and acceptability of a selfmanagement intervention (cognitive behavioral therapy [CBT-I]) for insomnia among patients with stable HF. Methods: We conducted a pilot randomized controlled trial (RCT) in which patients with stable Class I-III HF (n = 25/52.1% women; mean age = 59 ± 14.8 years) were randomized in groups to CBT-I (n = 29) or an attention control condition (HF self-management with sleep hygiene; n = 19). Participants completed 2 weeks of wrist actigraphy, the insomnia severity index, and measures of fatigue, depression, sleepiness, and functional performance at baseline and follow-up. We computed the size of the effects on the dependent variables and used MANOVA to evaluate the effects of CBT-I on insomnia and fatigue. Results: CBT-I was feasible and acceptable and had a statistically signifi cant effect on insomnia and fatigue, while controlling for the effects of comorbidity and age. Conclusions: CBT-I has short-term effi cacy as a treatment for chronic insomnia among patients with stable HF. Future studies are needed to address its sustained effects. Keywords: self-management, heart failure, insomnia, cognitive behavioral therapy, sleep, fatigue, depression Citation: Redeker NS, Jeon S, Andrews L, Cline J, Jacoby D, Mohsenin V. Feasibility and effi cacy of a self-management intervention for insomnia in stable heart failure. J Clin Sleep Med 2015;11(10):1109 -1119 .pii: jc-00335-14 http://dx.doi.org/10.5664/jcsm.5082 H eart failure (HF), a disabling chronic condition that affl icts over fi ve million Americans, 1 is associated with excess morbidity and mortality, comorbidity, poor daytime function, and high symptom burden. Almost 75% of HF patients report poor sleep.2,3 Insomnia, characterized by diffi culty initiating and maintaining sleep, early morning awakenings, non-restorative sleep, and daytime dysfunction, occurs in 25% to 56% of HF patients, 2-5 who report higher rates than "healthy" controls 2 and the general population. Chronic insomnia contributes to incident HF and death. 6 It is distressing and associated with symptoms, such as fatigue, nocturnal dyspnea, depression, anxiety, pain, and excessive daytime sleepiness, poor quality of life, and decrements in functional performance. 3,5,[7][8][9][10][11][12][13] Health care providers frequently attribute sleep disturbance, including insomnia symptoms, to the pathophysiology (e.g., fl uid congestion) and symptoms of HF itself (e.g., nocturnal dyspnea, nocturia) or to sleep disordered breathing that occurs in about half the population.14 However, sleep disordered breathing does not consistently explain insomnia, self-reported sleep quality, or fatigue; and insomnia was closely associated with...

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Randomized Trial of a Cognitive-Behavioral Intervention for Insomnia in Breast Cancer Survivors

Abstract: Breast cancer survivors can benefit from a cognitive-behavioral intervention for chronic insomnia. Sleep education and hygiene, a less complex treatment than a multicomponent intervention, also is effective in treating insomnia.

Cited by 134 publications

References 42 publications

Relationships Between Cause of Cancer and Breast Cancer-Related Factors in Breast Cancer Survivors

Relationships Between Cause of Cancer and Breast Cancer-Related Factors in Breast Cancer Survivors

Cancer-Related Fatigue: The Approach and Treatment

Feasibility and Efficacy of a Self-Management Intervention for Insomnia in Stable Heart Failure

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