Feasibility and efficacy of &#39;Can-Sleep&#39;: effects of a stepped-care approach to cognitive-behavioral therapy for insomnia in cancer

Diggens, J; Bullen, D; Maccora, J; Wiley, JF; Ellen, S; Goldin, J; Jefford, M; Hickey, M; Ftanou, M

Feasibility and efficacy of 'Can-Sleep': effects of a stepped-care approach to cognitive-behavioral therapy for insomnia in cancer

Author(s): Diggens, J; Bullen, D; Maccora, J; Wiley, JF; Ellen, S; Goldin, J; Jefford, M; Hickey, M; Ftanou, M;
Details: Publication Year 2025-02,Volume 19,Issue #1,Page 174-182
Journal Title: Journal of Cancer Survivorship
Publication Type: Research article
Abstract: PURPOSE: This study aimed to evaluate the feasibility and clinical efficacy of the Can-Sleep stepped-care intervention for people with cancer-related sleep disturbance. METHODS: A total of 147 individuals with cancer were screened. Participants who reported sleep disturbances and were at low-moderate risk for intrinsic sleep abnormalities were given self-managed cognitive behavioral therapy for insomnia (SMCBT-I). Those reporting sleep disturbance and scoring at high risk of intrinsic sleep abnormalities (i.e., restless leg syndrome and obstructive sleep apnoea) were referred to a specialist sleep clinic. In both groups, participants received a stepped-up group CBT-I intervention (GCBT-I) if they continued to report sleep disturbance following SMCBT-I or the specialist sleep clinic. RESULTS: Overall, 87 participants reported sleep disturbance or screened at risk for intrinsic sleep abnormality. Thirty-four were referred to a specialist sleep clinic, and of the 17 who declined this referral, 14 were rereferred to SMCBT-I. In total, 62 participants were referred to SMCBT-I, and 56 commenced SMCBT-I. At post-intervention, the SMCBT-I group showed a significant decline in insomnia symptoms (p < .001, d = 1.01). Five participants who reported sleep disturbance after SMCBT-I and/or the specialist sleep clinic, accepted GCBT-I. Those who received the GCBT-I showed a significant reduction in insomnia symptoms (p < .01, d = 3.13). CONCLUSIONS: This study demonstrates the feasibility and efficacy of a stepped-care intervention for sleep disturbances in people with cancer. IMPLICATIONS FOR CANCER SURVIVORS: A stepped-care intervention for sleep disturbance is a feasible and potentially effective method of addressing a significant and unmet patient need.
Keywords: Humans; *Sleep Initiation and Maintenance Disorders/therapy/etiology; Male; Female; *Cognitive Behavioral Therapy/methods; Middle Aged; *Feasibility Studies; *Neoplasms/complications/therapy; Aged; Adult; Treatment Outcome; Cancer; Cognitive behavioral therapy; Insomnia; Sleep; Stepped-care
Department(s): Psychosocial Oncology; Health Services Research; Australian Cancer Survivorship Centre; Medical Oncology
PubMed ID: 37751126
Publisher's Version: https://doi.org/10.1007/s11764-023-01457-3
Open Access at Publisher's Site: https://doi.org/10.1007/s11764-023-01457-3
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-11-14 03:57:59

Last Modified: 2025-03-14 07:08:03