Using Cognitive Behavioral Therapy to Manage Insomnia among Patients with Cancer

AbstractObjectiveInsomnia is a common, distressing, and impairing psychological outcome experienced by informal caregivers (ICs) of patients with cancer. Cognitive behavioral therapy for insomnia (CBT-I) and acupuncture both have known benefits for patients with cancer, but such benefits have yet to be evaluated among ICs. The purpose of the present study was to evaluate the feasibility, acceptability and preliminary effects of CBT-I and acupuncture among ICs with moderate or greater levels of insomnia.MethodParticipants were randomized to eight sessions of CBT-I or ten sessions of acupuncture.ResultsResults highlighted challenges of identifying interested and eligible ICs and the impact of perception of intervention on retention and likely ultimately outcome.Significance of the resultsFindings suggest preliminary support for non-pharmacological interventions to treat insomnia in ICs and emphasize the importance of matching treatment modality to the preferences and needs of ICs.

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The Effectiveness of Cognitive Behavioral Therapy (CBT) To Decreased Depression in Woman Patients with Cancer included cervical cancer and breast cancer

Jurnal Ners dan Kebidanan Indonesia ◽

10.21927/jnki.2018.6(3).27-34 ◽

2019 ◽

Vol 6 (3) ◽

pp. 27

Author(s):

Dwi Fitriyanti ◽

Mardiyono Mardiyono ◽

Yuriz Bakhtiar

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cervical Cancer ◽

Cognitive Behavioral Therapy ◽

Cause Of Death ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Future Research ◽

Newly Diagnosed ◽

Patients With Cancer

<em>The highest cancers in Indonesia in women are breast cancer and cervical cancer. Both are the most common cancers in women and the highest cause of death in women. Some woman patients with newly diagnosed of breast cancer or cervical cancer will experience depression. most patients newly diagnosed with cancer, less than 6 months reported a feeling of depression of 91.4%. An effective intervention to reduce the level of depression is to provide cognitive behavioral therapy (CBT) interventions. CBT is a psychotherapy recommended for treating depression in patients with breast cancer and cervical cancer. The objective of this study to review the effects of CBT on decreasing depression in woman patients with cancer including cervical cancer and breast cancer. This study is a systematic review. We search articles from EBSCOhost, Google Scholar, Pubmed, and Science Direct database which published from 2008 till 2018. RCTs are included in this review. Four RCTs included in this study. CBT interventions are carried out differently for each article, in general, each session is given for 60-90 minutes with a different number of sessions. Outcome measured in 3 articles was more than one variable (not only depression) and one article only measured the level of depression. Cognitive behavioral therapy can be used for woman patients with breast cancer and cervical cancer who are depressed. Future research to the effectiveness of CBT in reducing depression in woman patients specifically in newly diagnosed with cervical cancer is needed to confirm the evidence</em>

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Insomnia in cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18651 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18651-e18651

Author(s):

Sara Ashraf ◽

Mohammad Ali Syed Jafri ◽

Mohamed Farouq Alsharedi

Keyword(s):

Cognitive Behavioral Therapy ◽

Sleep Disturbances ◽

Early Stage ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Cancer Center ◽

Advanced Stage ◽

Nccn Guidelines ◽

Patients With Cancer ◽

Stage Disease

e18651 Background: Insomnia is a prevalent, debilitating problem that is faced by a growing number of patients with cancer. These patients are at higher risk of excessive fatigue, anxiety, depression, less immunity and poor adherence to treatment. A recommendation by the National Comprehensive Cancer Network (NCCN) Guidelines is to routinely screen patients for sleeps issues. We sought to analyze the screening for insomnia and its management at a cancer center in Appalachia. We also evaluated referrals for cognitive behavioral therapy, which is recommended as first line therapy in patients with chronic insomnia by the American College of Physicians (ACP). Methods: We performed an anonymous survey related to sleep at our cancer center which included 312 patients diagnosed with a solid tumor malignancy divided into early stage (stage I or II) or advanced stage (stage III or IV). Three questions were directly from NCCN guidelines screening for sleep disturbances in patients with cancer. We also added questions regarding if the patients’ medical oncologists ever asked about or addressed their sleep difficulties and if any treatment was offered. The institutional review board of the cancer center approved this study. Results: Our results showed that 67.9% (212 patients) reported either having difficulty falling asleep, staying asleep, or waking up too early. 14.7% (46 patients) reported excessive sleepiness, while 64.7% (202 patients) reported that someone else told them that they snore frequently or stop breathing while sleeping. Of the patients who reported difficulty with sleep, only 4.7% (10 patients) reported that their medical oncologist ever addressed it, with 7 patients being started on medication. No patients were referred for cognitive behavioral therapy. Patients with advanced stage disease were four times more likely to report disturbances with sleep than early stage disease. Conclusions: Patients with cancer have difficulty with sleep, which profoundly affects their quality of life and may negatively impact their response to treatment. We wanted to use this survey to see how we can improve efforts to routinely screen patients and identify those in need of assistance and therapy. Routine screening and initiation of treatment must be implemented nationwide in all cancer centers. We aim to start referrals for cognitive behavioral therapy and continue to address patients’ sleep disturbances on a routine basis.

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Cognitive-Behavioral Therapy for Insomnia in Patients With Cancer

Clinical Journal of Oncology Nursing ◽

10.1188/11.cjon.e42-e52 ◽

2011 ◽

Vol 15 (4) ◽

pp. E42-E52 ◽

Cited By ~ 14

Author(s):

Susan Crump Woodward

Keyword(s):

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Patients With Cancer

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Cognitive Behavioral Therapy for Psychological Distress, Self Care and Quality of Life in Patients with Cancer: A Meta-analysis

Korean Journal of Adult Nursing ◽

10.7475/kjan.2013.25.4.377 ◽

2013 ◽

Vol 25 (4) ◽

pp. 377 ◽

Cited By ~ 5

Author(s):

Pok Ja Oh ◽

Eun Ai Lee

Keyword(s):

Quality Of Life ◽

Psychological Distress ◽

Cognitive Behavioral Therapy ◽

Behavioral Therapy ◽

Meta Analysis ◽

Self Care ◽

Cognitive Behavioral ◽

Patients With Cancer

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Mindfulness-Based Stress Reduction Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia Comorbid With Cancer: A Randomized, Partially Blinded, Noninferiority Trial

Journal of Clinical Oncology ◽

10.1200/jco.2012.47.7265 ◽

2014 ◽

Vol 32 (5) ◽

pp. 449-457 ◽

Cited By ~ 157

Author(s):

Sheila N. Garland ◽

Linda E. Carlson ◽

Alisa J. Stephens ◽

Michael C. Antle ◽

Charles Samuels ◽

...

Keyword(s):

Cognitive Behavioral Therapy ◽

Sleep Quality ◽

Stress Reduction ◽

Behavioral Therapy ◽

Sleep Onset ◽

Cognitive Behavioral ◽

Patients With Cancer ◽

Mindfulness Based Stress Reduction ◽

Insomnia Severity

Purpose Our study examined whether mindfulness-based stress reduction (MBSR) is noninferior to cognitive behavioral therapy for insomnia (CBT-I) for the treatment of insomnia in patients with cancer. Patients and Methods This was a randomized, partially blinded, noninferiority trial involving patients with cancer with insomnia recruited from a tertiary cancer center in Calgary, Alberta, Canada, from September 2008 to March 2011. Assessments were conducted at baseline, after the program, and after 3 months of follow-up. The noninferiority margin was 4 points measured by the Insomnia Severity Index. Sleep diaries and actigraphy measured sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency. Secondary outcomes included sleep quality, sleep beliefs, mood, and stress. Results Of 327 patients screened, 111 were randomly assigned (CBT-I, n = 47; MBSR, n = 64). MBSR was inferior to CBT-I for improving insomnia severity immediately after the program (P = .35), but MBSR demonstrated noninferiority at follow-up (P = .02). Sleep diary–measured SOL was reduced by 22 minutes in the CBT-I group and by 14 minutes in the MBSR group at follow-up. Similar reductions in WASO were observed for both groups. TST increased by 0.60 hours for CBT-I and 0.75 hours for MBSR. CBT-I improved sleep quality (P < .001) and dysfunctional sleep beliefs (P < .001), whereas both groups experienced reduced stress (P < .001) and mood disturbance (P < .001). Conclusion Although MBSR produced a clinically significant change in sleep and psychological outcomes, CBT-I was associated with rapid and durable improvement and remains the best choice for the nonpharmacologic treatment of insomnia.

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