Treating Insomnia with CBT in Women with Breast Cancer
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Introduction: It has been reported that women with breast cancer have complaints about poor sleep, insomnia, and fatigue. Research has shown that these complaints may persist years after treatment and that they may represent a significant source of distress and diminished quality of life. Only one study has analyzed the effects of treating insomnia with Cognitive Behavioral Therapy (CBT) in women with breast cancer and it found significant improvements in sleep efficiency, total sleep time, mood and cognitive aspects of quality of life. However, this study did not have a control group and so questions about possible placebo effects still need to be addressed.
 
 
 
 
 
 
 
 The main objective of this research is to evaluate the efficacy of group CBT sessions for insomnia in women with breast cancer. A secondary objective of this research is to study the effect of group CBT insomnia treatment on variables often related to insomnia such as fatigue, depression, anxiety, and quality of life.
 
 
 
 
 
 
 
 Hypothesis: CBT will be effective in improving objective and subjective insomnia in women with breast cancer.
 
 • Is cognitive behavioral therapy an efficacious treatment for insomnia (measured both objectively and subjectively) in women with breast cancer?
 
 Hypothesis: Improving insomnia will result in improved quality of life, decreased fatigue, improved mood, and decreased anxiety
 
 • Does treating insomnia with CBT in women with breast cancer improve quality of life, and decrease levels of fatigue, depression and anxiety?
 
 
 
 
 
 
 
 Methodology: Twenty-four women who survived breast cancer and who have completed chemotherapy or radiotherapy but still suffer from insomnia with no other psychiatric disorder (DSM IV-R guidelines) or medical illness will be recruited. The 24 women will be randomly assigned to either a six week manualized group CBT for insomnia condition or a six week treatment as usual condition (i.e., control group). 
 
 
 
 
 
 
 
 The two groups will be compared on objective sleep measures (actigraphy) corroborated by sleep diaries, and standardized questionnaires on insomnia (ISI), sleep quality (PSQI), daytime functional outcomes of sleepiness (FOSQ), fatigue (MFSI), quality of life (SF36), depression (CESD), and anxiety (BSI-18). Data will be collected before the start of treatment and six weeks later at the end of treatment.
 
 
 
 
 
 
 
 Impact on breast cancer: Insomnia is a debilitating condition that affects many aspects of daily life such as daytime sleepiness, energy, attention, cognitive functioning, and mood. When survivors of breast cancer experience insomnia the healing process from the traumatic, psychologically and physically distressing event might be weakened by the direct effects of the insomnia or other correlated symptoms. If so, successfully treating insomnia in breast cancer survivors would significantly improve health and quality of life in this population.
 
 
 
 
 
 
 
 Advocacy involvement: Advocacy websites (e.g., www.breastcancer.orq, www.bcaction2rg, www.y-me.org) will be frequently visited. Information on general and the specific sleep, fatigue and quality of life needs in this population will be sought out in order to gear the intervention towards taking care of those needs. We are integrally involved with the UCSD community outreach program's efforts to help women cope with and find solutions for cancer related fatigue. Particular attention is placed on the needs of the underserved minorities. Dr. Sadler, our co-investigator, is the UCSD Cancer Center's Associate Director for Community Outreach and works closely with ustincrease advocacy involvement.