Feasibility and acceptability of brief behavioral therapy for cancer-related insomnia: effects on insomnia and circadian rhythm during chemotherapy: a phase II randomised multicentre controlled trial

• Published in: British journal of cancer Vol. 119; no. 3; pp. 274 - 281
• Main Authors: Palesh, Oxana, Scheiber, Caroline, Kesler, Shelli, Janelsins, Michelle C., Guido, Joseph J., Heckler, Charles, Cases, Mallory G., Miller, Jessica, Chrysson, Nick G., Mustian, Karen M.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2018; Nature Publishing Group
• Subjects: 692/308/2779/777; 692/700/784; Acceptability; Behavior modification; Benchmarks; Biomedical and Life Sciences; Biomedicine; Breast cancer; Cancer; Cancer Research; Chemotherapy; Circadian rhythm; Circadian Rhythm - genetics; Circadian rhythms; Cognitive Behavioral Therapy; Drug Resistance; Epidemiology; Exercise; Feasibility; Feasibility Studies; Female; Humans; Insomnia; Male; Middle Aged; Molecular Medicine; Neoplasms - complications; Neoplasms - genetics; Neoplasms - physiopathology; Neoplasms - therapy; Oncology; Randomization; Sleep - genetics; Sleep - physiology; Sleep disorders; Sleep Initiation and Maintenance Disorders - complications; Sleep Initiation and Maintenance Disorders - genetics; Sleep Initiation and Maintenance Disorders - physiopathology; Sleep Initiation and Maintenance Disorders - therapy; Sleep Wake Disorders - complications; Sleep Wake Disorders - physiopathology; Sleep Wake Disorders - therapy; Surveys and Questionnaires; Teaching methods; Treatment Outcome; Wrist
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/s41416-018-0154-2

Background This phase II RCT was conducted to determine the feasibility and acceptability of brief behavioral therapy for cancer-related insomnia (BBT-CI) in breast cancer patients undergoing chemotherapy. We also assessed the preliminary effects of BBT-CI on insomnia and circadian rhythm in comparison to a Healthy Eating Education Learning control condition (HEAL). Methods Of the 71 participants recruited, 34 were randomised to receive BBT-CI and 37 to receive HEAL. Oncology staff was trained to deliver the intervention in four community clinics affiliated with the NCI. Insomnia was assessed with the Insomnia Severity Index (ISI), and circadian rhythm was assessed using a wrist-worn actiwatch. Results Community staff interveners delivered 72% of the intervention components, with a recruitment rate of 77% and an adherence rate of 73%, meeting acceptability and feasibility benchmarks. Those randomised to BBT-CI improved their ISI scores by 6.3 points compared to a 2.5-point improvement in those randomised to HEAL ( P  = 0.041). Actigraphy data indicated that circadian functioning improved in the BBT-CI arm as compared to the HEAL arm at post-intervention (all P -values <0.05). Conclusions BBT-CI is an acceptable and feasible intervention that can be delivered directly in the community oncology setting by trained staff. The BBT-CI arm experienced significant improvements in insomnia and circadian rhythm as compared to the control condition.