Insomnia in Cancer Survivors

Insomnia is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep or cause you to wake up too early and not able to get back to sleep. Cognitive behavior therapy or CBT focuses on the development of personal coping strategies that helps the patient identify and replace thoughts and behaviors that cause or worsen sleep problems.¹

Studying insomnia in cancer survivors

A randomized clinical trial of cancer survivors showed that 8 weeks of either acupuncture or cognitive behavioral therapy reduced levels of insomnia among the participants. The findings were presented at the 2018 American Society of Clinical Oncology Annual Meeting. According to the lead study author, Jun J. Mao, MD, “up to 60% of cancer survivors have some form of insomnia, but it is often underdiagnosed and undertreated”.²

The cancer survivors in the trial had completed treatment and were typically several years out from their initial diagnosis. The trial participants had been treated for breast, prostate, head and neck, blood and colorectal cancers. Trial participants were randomly assigned to receive either CBT or acupuncture. Acupuncture includes placing needles in areas of the body that are thought to impact sleep.

The CBT component involved participants working with a therapist to develop good sleep habits and avoid behaviors that can keep you from sleeping. This included,

• Removing things that condition your mind to resist sleep.
• Try to have a set a consistent bedtime, avoid naps that may make falling asleep at bedtime more difficult, and use the bed for only sleep and sexual activity.
• Create a comfortable sleep environment. This may mean keeping the bedroom dark and quiet, and limiting use of cell phones and other electronics.
• Avoid too much caffeine in the day, wind down an hour or two before bedtime.¹

The Insomnia Severity Index was used to measure changes in insomnia. This questionnaire asked participants to rate "insomnia problems, difficulty falling asleep, staying asleep and the impact of insomnia on daily activities and quality of life."²

Results

The results demonstrated that CBT was the more effective treatment than acupuncture. Cancer survivors who participated in the study "maintained improvement in insomnia for up to 20 weeks after the start of the trial."²

Cognitive behavioral therapy offers a structured program that helps patients identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep.

Further information about insomnia and possible treatments can be found through the American Academy of Sleep Medicine or the Society of Behavioral Sleep Medicine.

Have you experienced trouble with sleeping during your cancer journey? Have you found anything that helps to improve your insomnia?