Insomnia in adult patients with cancer: ESMO Clinical Practice Guideline

The time has come for national clinical practice guidelines for managing late effects after cancer and cancer treatment

“…International and national organizations such as the European Society of Medical Oncologists (ESMO), the National Comprehensive Cancer Network (NCCN), and the American Society of Clinical Oncologists (ASCO) have published clinical guidelines both for survivorship in general, e.g., [1,2], and for the management of specific symptoms and late effects, e.g., anxiety and depression [3], insomnia [4], and fatigue [5]. However, to support the implementation of the best evidencebased approaches to manage late effects, there is also a need for national guidelines supporting the integration of the international initiatives at the national level.…”

“…While chronic insomnia is the most common sleep disturbance experienced by approximately 10% of the general population, it is, on average, three times more prevalent in cancer survivors [9]. As is the case in the existing guidelines for insomnia in the general population, international guidelines for managing insomnia in cancer survivors [4] recommend cognitive behavioral therapy for insomnia (CBTI) as first-line treatment. In contrast, the limited evidence for hypnotics does not outweigh the side effects and risks of adverse events associated with long-term use.…”