Author:
Diggens Justine,Bullen Dani,Maccora Jordan,Wiley Joshua F.,Ellen Steve,Goldin Jeremy,Jefford Michael,Hickey Martha,Ftanou Maria
Abstract
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.
Funder
Department of Health, State Government of Victoria
National Health and Medical Research Council
Publisher
Springer Science and Business Media LLC
Subject
Oncology (nursing),Oncology
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