Non-Drug Therapy Can Help Insomnia in Cancer Survivors, But More Research Is Needed in Those Undergoing Treatment

Cognitive behavioral therapy has been proven to improve insomnia in cancer survivors, but research is lacking in patients who are currently undergoing treatment or who have advanced disease.

Cognitive behavioral therapy has been shown to improve insomnia in cancer survivors; however, research is lacking in whether it benefits patients with advanced-stage cancer and those undergoing active treatment, according to results of a study presented at the 47th Annual Oncology Nursing Society Congress.

Eugenie Spiguel, a nurse practitioner in integrative medicine at Memorial Sloan Kettering Cancer Center in New York, explained that patients with cancer often experience insomnia at a rate of two or three times higher than the general population. And it is often treated with medication, which is not always suitable for patients who do not want an added mediation and the potential side effects that come along with it.

The American College of Physicians recommends cognitive behavioral therapy as first-line treatment for insomnia, and Spiguel sought to evaluate if this was an effective treatment option for patients with cancer based on previous studies.

She found 19 studies evaluating cognitive behavioral therapy for insomnia. The studies included methods such as group therapy, telemedicine and shortened versions of the typical visits for cognitive behavioral therapy (from six visits to two).

“By and large the findings were overwhelmingly positive, so there was an improvement in many insomnia parameters,” Spiguel said during the presentation. Improvements were observed in the time it took to fall asleep, the ability to stay asleep and waking up early.

However, most of these studies only included cancer survivors and not patients currently undergoing treatment.

“And that is unfortunate only in that we already know that it’s effective in the general population, (and) the survivorship population coincides with that,” she said. Spiguel hopes that patients undergoing active treatment can be included in future studies.

“I would love to see more research done on patients who are undergoing treatment or in the advanced cancer (stage) population,” she added.

She concluded in saying that treating insomnia in patients with cancer is easy to implement into daily practice and is rewarding.

“If we find that patients are having insomnia, we can easily intervene with a non-drug therapy. I do this myself in my own clinic and it is extremely rewarding to see somebody improve, to see their insomnia really get better,” Spiguel concluded.


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