A novel approach to management of sleep-associated problems in patients with breast cancer (MOSAIC) during chemotherapy : A pilot study

Abstract

Study Objectives This pilot randomized controlled trial (RCT) was conducted to assess the preliminary effects of Brief Behavioral Therapy for Cancer-Related Insomnia (BBT-CI) delivered by trained research staff in comparison to a sleep hygiene pamphlet control and to assess moderators of treatment effect in patients with breast cancer undergoing chemotherapy. Methods Of 74 participants recruited, 37 were randomized to BBT-CI and 37 were randomized to the control condition. Trained staff members delivered the intervention during chemotherapy treatments to reduce patients’ burden. Insomnia was assessed with the Insomnia Severity Index (ISI), anxiety was assessed with the Spielberger State-Trait Anxiety Inventory, symptom burden was assessed with the Symptom Inventory (SI), and study staff recorded previous treatments and surgeries received by patients. Results Patients randomized to BBT-CI showed significantly greater improvements in their ISI scores compared to the sleep hygiene group. Additionally, several treatment moderators were identified. The effect of BBT-CI was greater among individuals with lower baseline state-trait anxiety, with previous surgery for cancer, and with higher baseline somatic symptom severity. Conclusions BBT-CI shows preliminary efficacy compared to the sleep hygiene handout on insomnia in cancer patients undergoing chemotherapy. A large-phase III RCT needs to be conducted to replicate the preliminary findings.

The Survivorship Sleep Program (SSP): A synchronous, virtual cognitive behavioral therapy for insomnia pilot program among cancer survivors

“…17,18 Remotely delivered CBT-I interventions have largely relied on technologies that are asynchronous (eg, video recordings 35 ), lack a facilitator (eg, an app or website 16,[19][20][21][22]36 ), or have hybrid in-person and remote sessions (eg, brief behavioral therapy for insomnia 37 ). As noted previously, 35,38 survivors expressed that professional support is necessary to stay engaged in CBT-I sessions and to personalize treatment based on cancer-related experiences. These preferences were substantiated by our RCT findings, which demonstrated rates of session attendance (100%) and retention across assessments (90% at 1month follow-up) that were higher than in other CBT-I trials among cancer survivors.…”

Electroacupuncture Plus Auricular Acupressure for Chemotherapy-Associated Insomnia in Breast Cancer Patients: A Pilot Randomized Controlled Trial

“…Among cancer survivors who had completed active treatment (including surgery, chemotherapy, and radiotherapy), Garland et al 12 found that 8-week of treatment produced 8.3 points reduction in ISI in acupuncture group and 10.9 points in cognitive behavioral therapy group respectively compared to pre-treatment.In our study, 6-week of acupuncture treatment produced 6.6 points reduction in ISI compared to pre-treatment among breast cancer patients undergoing active treatments. In another study, Palesh et al 37 investigated the effectiveness of brief behavioral therapy for insomnia among breast cancer patients receiving chemotherapy, and found that 6-week of treatment produced around 5 points reduction in ISI as compared with pre-treatment. Cancer survivors who had completed active cancer treatment seemed to benefit more from acupuncture or behavioral therapy as compared to those who were undergoing active treatment.…”

Headache outcomes of a sleep behavioral intervention in breast cancer survivors: Secondary analysis of a randomized clinical trial

“…The study interventions are described elsewhere in detail 24,33,34 . Briefly, BBT‐CI consisted of 6 sessions: 2 face‐to‐face sessions and four 15‐minute phone calls, including the following components: 1) chronorehabilitation education and techniques (eg, the connection between sleep, circadian disruption, and cancer), 2) light and stimulus control (increase light exposure during the day, minimize light exposure at night; education about melatonin as a circadian hormone; and associate the bed with sleep and sex only), 3) encouragement of sleep activity and protocol for napping, and 4) sleep compression (go to bed later by 15 minutes if sleep quality is low).…”