Behavioral therapies may help cancer patients sleep better

Cancer patients plagued by sleeping problems need no longer resort to traditional sleep-inducing medication. A new study, published online in the Journal of Clinical Oncology, showed that there are two behavioral interventions available to cancer patients that can help relieve the symptoms of insomnia: cognitive behavioral therapy for insomnia (CBT-I) and mindfulness-based stress reduction (MBSR).

Penn Medicine researchers studied 111 cancer patients for eight months in Calgary, Alberta, Canada, and assigned 47 of these patients to undergo CBT-I, and 64 were assigned to undergo MBSR. At the end of the treatment protocol, the researchers found that both CBT-I and MBSR reduced insomnia severity across each group, but the effects in the CBT-I group set in much faster, while patients from the MBSR group tended to show a much slower improvement. However, both groups have noticeably improved their sleep time, and tended to fall asleep faster, leading to improvements in mood and a decrease in stress-related symptoms.

CBT consists of therapist-guided sessions that teach patients certain methods that will help them get better sleep, such as relaxation techniques and good sleeping habits, and how to ignore stimuli. But for people without access to this, videoconferencing is available, and was shown to deliver good results as well.

In a different study published in the journal Sleep Medicine, researchers recruited 73 adults in Canada and divided them into two groups. One group was given CBT through an Internet-based program and the other group was assigned to undergo group videoconferencing at clinics near their homes.

After six weeks worth of CBT sessions, 55 percent of the video conference group and 62 percent of the web-based group marked a significant drop in insomnia symptoms.

Chronic insomnia is characterized by difficulty in falling asleep, the tendency to wake up in the middle of the night and too early in the morning, leading to a general feeling of tiredness during the day. Many cancer patients experience chronic insomnia due to either pain or as side effect of ongoing cancer medication, and many of them refuse to take additional medication for insomnia for fear of having to deal with additional side effects or the increased possibility of becoming dependent on sleep medication.

There are between 36 to 59 percent of cancer patients that have trouble falling asleep and staying asleep during and after the completion of cancer treatment. Up to 28 percent of cases are formally diagnosed as insomnia. About 1 in 10 Americans suffers from chronic insomnia, and the Centers for Disease Control and Prevention reports that over 25 percent of people in the U.S. report that they occasionally have trouble getting enough sleep.

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