Bright light shows promise in improving sleep, depression, and quality of life in women with breast cancer during chemotherapy: findings of a pilot study

Wu, Haijun; Davis, Jean E.; Chen, L

doi:10.1080/07420528.2021.1871914

Cited by 18 publications

(8 citation statements)

References 32 publications

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“…Aromatherapy as a stress-relieving aid during the sleep phase may also lead to a significant improvement in sleep quality [102]. A more physiological approach based on treatment with bright light for 30 min per day was found to significantly improve sleep and circadian function in breast cancer patients [103], suggesting that an over-exposure to light during the day can help normalize the circadian function of the patient. While sedatives/hypnotics are commonly used for treatment of sleep disruptions [99], the 2016 national comprehensive cancer network guidelines recommend against this practice, at least if used as a monotherapy [104].…”

Section: Normalizing Sleep and Circadian Function In Cancer Patientsmentioning

confidence: 99%

Section: Update On the Known Consequences Of Sleep/circadian Disruptionmentioning

confidence: 99%

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A multidisciplinary perspective on the complex interactions between sleep, circadian, and metabolic disruption in cancer patients

Jensen

Oliva

Andersson

et al. 2021

Cancer Metastasis Rev

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Sleep is a basic need that is frequently set aside in modern societies. This leads to profound but complex physiological maladaptations in the body commonly referred to as circadian disruption, which recently has been characterized as a carcinogenic factor and reason for poor treatment outcomes, shortened survival, and reduced quality of life in cancer patients. As sleep and circadian physiology in cancer patients spans several disciplines including nursing science, neurology, oncology, molecular biology and medical technology, there is a lack of comprehensive and integrated approaches to deal with this serious and growing issue and at best a fractionated understanding of only part of the problem among researchers within each of these segments. Here, we take a multidisciplinary approach to comprehensively review the diagnosis and impact of sleep and circadian disruption in cancer patients. We discuss recent discoveries on molecular regulation of the circadian clock in healthy and malignant cells, the neurological and endocrine pathways controlling sleep and circadian rhythmicity, and their inputs to and outputs from the organism. The benefits and drawbacks of the various technologies, devices, and instruments used to assess sleep and circadian function, as well as the known consequences of sleep disruption and how sleep can be corrected in cancer patients, will be analyzed. We will throughout the review highlight the extensive crosstalk between sleep, circadian rhythms, and metabolic pathways involved in malignancy and identify current knowledge gaps and barriers for addressing the issue of sleep and circadian disruption in cancer patients. By addressing these issues, we hope to provide a foundation for further research as well as better and more effective care for the patients in the future.

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Section: Normalizing Sleep and Circadian Function In Cancer Patientsmentioning

confidence: 99%

Section: Update On the Known Consequences Of Sleep/circadian Disruptionmentioning

confidence: 99%

A multidisciplinary perspective on the complex interactions between sleep, circadian, and metabolic disruption in cancer patients

Jensen

Oliva

Andersson

et al. 2021

Cancer Metastasis Rev

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“…To our knowledge, no trial to date has combined brief CBT-I with BL to target the multiple causes of poor sleep during chemotherapy. A recent trial examined the effects of 21 days of bright light therapy only in this population and showed some benefit for sleep, depression and quality of life, however improvements in subjective sleep quality and fatigue were not statistically significant 54 . Comparatively, outcomes of the present trial may be indicative of the benefit in combining CBT-I and light therapy, or a longer intervention duration.…”

Section: Discussionmentioning

confidence: 98%

Light Enhanced Cognitive Behavioral Therapy (CBT₊) for Insomnia and Fatigue During Chemotherapy for Breast Cancer: A Randomized Controlled Trial

Bean

Diggens

Ftanou

et al. 2021

Preprint

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Study Objectives Sleep problems are common during chemotherapy for breast cancer (BC). We evaluated whether combined brief cognitive behavioral and bright light therapy (CBT+) is superior to treatment as usual with relaxation audio (TAU+) for insomnia symptoms and sleep efficiency (primary outcomes). Methods We randomized women receiving intravenous chemotherapy, stratified by tumor stage and insomnia severity index (ISI), to 6-weeks CBT+ or TAU+. CBT+ included one in-person session, one telephone call, seven emails, and 20 minutes bright light each morning. TAU+ comprised usual treatment and two emails with relaxation audio tracks. Patient-reported outcomes were assessed at baseline, midpoint (week 3), post (week 6) and 3-month follow-up. Results Women (N = 101) were randomly assigned to CBT+ or TAU+. Insomnia symptoms declined significantly more from baseline to post with CBT+ versus TAU+ (-5.06 vs -1.93, P = .009; effect size [ES] = .69). At 3-month follow-up, both groups had improved insomnia symptoms but did not differ (ES = .18, P = .56). CBT+ had higher patient-reported sleep efficiency than TAU+ after the start of intervention (P = .05) and more improvement in fatigue (ES = .59, P = .013) and daytime sleep-related impairment (ES = .61, P = .009) from baseline to post. Conclusions CBT+ had a clinically significant impact on insomnia and fatigue with moderate effect sizes. Results support offering cognitive behavioral therapy for insomnia and bright light therapy during chemotherapy for breast cancer to help manage sleep and fatigue. Clinical trial information: Registered with the Australian New Zealand Clinical Trials Registry (http://anzctr.org.au/), Registration Number: ACTRN12618001255279

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“…(2021) 102 (RCT) Bright light therapy Breast cancer (active) II C Wu et al. (2021) 108 (RCT) Ovarian or endometrial cancer (survivors) II C Fox et al. (2021) 107 (RCT) BBT-I, brief behavioural therapy for insomnia; CBT-I, cognitive behavioural therapy for insomnia; eCBT-I, digitally delivered cognitive behavioural therapy for insomnia; GoR, grade of recommendation; LoE, level of evidence; MBT, mindfulness-based therapy; RCT, randomised controlled trial; SRMA, systematic review and meta-analysis.…”

Section: Managementmentioning

confidence: 99%

Insomnia in adult patients with cancer: ESMO Clinical Practice Guideline

Grassi,

Zachariae,

Caruso

et al. 2023

ESMO Open

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Bright light shows promise in improving sleep, depression, and quality of life in women with breast cancer during chemotherapy: findings of a pilot study

Cited by 18 publications

References 32 publications

A multidisciplinary perspective on the complex interactions between sleep, circadian, and metabolic disruption in cancer patients

A multidisciplinary perspective on the complex interactions between sleep, circadian, and metabolic disruption in cancer patients

Light Enhanced Cognitive Behavioral Therapy (CBT₊) for Insomnia and Fatigue During Chemotherapy for Breast Cancer: A Randomized Controlled Trial

Insomnia in adult patients with cancer: ESMO Clinical Practice Guideline

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Bright light shows promise in improving sleep, depression, and quality of life in women with breast cancer during chemotherapy: findings of a pilot study

Cited by 18 publications

References 32 publications

A multidisciplinary perspective on the complex interactions between sleep, circadian, and metabolic disruption in cancer patients

A multidisciplinary perspective on the complex interactions between sleep, circadian, and metabolic disruption in cancer patients

Light Enhanced Cognitive Behavioral Therapy (CBT+) for Insomnia and Fatigue During Chemotherapy for Breast Cancer: A Randomized Controlled Trial

Insomnia in adult patients with cancer: ESMO Clinical Practice Guideline

Contact Info

Product

Resources

About

Light Enhanced Cognitive Behavioral Therapy (CBT₊) for Insomnia and Fatigue During Chemotherapy for Breast Cancer: A Randomized Controlled Trial