Efficacy of a Stepped-Care Approach to Cognitive-Behavioural Therapy for Insomnia (Can-Sleep) in Adolescents and Young Adults With Cancer

Maccora, J; Ftanou, M; Vaughan, E; Murnane, A; Lewin, J; Berger, I; Wiley, JF; Jefford, M; Hickey, M; Goldin, J; Thompson, K

Author(s): Maccora, J; Ftanou, M; Vaughan, E; Murnane, A; Lewin, J; Berger, I; Wiley, JF; Jefford, M; Hickey, M; Goldin, J; Thompson, K;
Details: Publication Year 2026-08,Volume 35,Issue #8,Page e70549
Journal Title: Psycho-Oncology
Publication Type: Research article
Abstract: OBJECTIVE: Poor sleep is a common issue among adolescents and young adults (AYA) with cancer. The present study describes the feasibility and impact of the Can-Sleep stepped-care intervention for AYA with cancer. METHODS: A total of 51 AYA with cancer were screened. AYA who reported sleep disturbance (defined as insomnia severity index score [ISI] > 7) received self-managed cognitive behavioural therapy for insomnia (SMCBT-I) in the first instance (Step 1) followed by individual cognitive behavioural therapy for insomnia (ICBT-I) if symptoms continued (Step 2). AYA screened as high risk for intrinsic sleep abnormalities (e.g., obstructive sleep apnoea) were referred to a specialised service. RESULTS: Of the 51 AYA, 38 participants reported sleep disturbance. In total, 37 AYA commenced SMCBT-I, four attending the specialised sleep service prior. Thirty-one (84%) completed Step 1. Of these, 45% improved and required no further treatment, and 55% (17) were eligible for ICBT-I (ISI > 7). Following intervention, the SMCBT-I group showed a significant decline in insomnia symptoms (p < 0.001, d = 0.84). Among the 17 AYA continuing to report sleep disturbance, 11 (65%) were referred to ICBT-I, with 8 (73%) accepting and completing Step 2. Those who received the ICBT-I showed a significant reduction in insomnia symptoms (p = 0.007, d = 1.33). CONCLUSIONS: This study provides preliminary efficacy and acceptability of a stepped-care intervention for sleep disturbances in AYA with cancer. A stepped-care intervention may offer an effective and resource-efficient method for managing sleep disturbance in AYA with cancer.
Publisher: Wiley
Keywords: Humans; *Sleep Initiation and Maintenance Disorders/therapy/psychology/etiology; *Cognitive Behavioral Therapy/methods; Female; Adolescent; *Neoplasms/complications/psychology; Young Adult; Male; Treatment Outcome; Adult; Feasibility Studies; Self Care; cancer; cognitive behavioural therapy; insomnia; oncology; stepped‐care
Department(s): Psychosocial Oncology; AYA Cancer Service; Australian Cancer Survivorship Centre; Health Services Research
Publisher's Version: https://doi.org/10.1002/pon.70549
Open Access at Publisher's Site: https://doi.org/10.1002/pon.70549
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-09-14 12:01:07

Last Modified: 2026-09-14 12:01:21