Insomnia can be a late effect experienced by cancer survivors, but researchers at Dana-Farber Cancer Institute in Boston report that a stepped-care approach may help treat it.
In an ongoing clinical trial, the researchers examined insomnia levels in 43 survivors (mostly women) of primarily breast and blood cancers. The mean time since diagnosis was 11 years. All survivors had an elevated Insomnia Severity Index (ISI) score.
Each participant received an education session on basic sleep hygiene and was assessed four weeks later. Fifty-four percent (23 survivors) no longer had clinically elevated ISI scores following the single session.
However, 20 survivors reported persistent insomnia. Nine received more intense treatment, consisting of three sessions of cognitive behavioral therapy (CBT) in a group setting, and completed the ISI again prior to therapy and at four weeks post-treatment. Following CBT, 67 percent of survivors no longer had clinically elevated ISI scores.
The researchers noted that a sleep hygiene intervention can be delivered by nonspecialists or through mobile intervention. Additionally, a short-duration group CBT intervention is effective and requires fewer resources than standard CBT insomnia treatment, they wrote.