Espie, C. A., Fleming, L., Cassidy, J., Samuel, L., Taylor, L. M., White, C. A., . . . Paul, J. (2008). Randomized controlled clinical effectiveness trial of cognitive behavior therapy compared with treatment as usual for persistent insomnia in patients with cancer. Journal of Clinical Oncology, 26, 4651–4658.doi: 10.1200/JCO.2007.13.9006
To investigate the clinical effectiveness of cognitive-behavioral therapy (CBT) for insomnia delivered by oncology nurses.
Patients received five 50-minute small group sessions delivered across five consecutive weeks, following a manualized protocol. Sessions included sleep information, sleep hygiene and relaxation, sleep scheduling, cognitive approaches, and developing a strong and natural sleep pattern. Outcomes measured were sleep, health-related quality of life (QOL), psychopathology, and fatigue.
The study was conducted at two oncology clinics in Scotland.
Patients were undergoing the follow-up phase of care.
This was a randomized, controlled trial.
CBT was associated with mean reductions in wakefulness of 55 minutes per night compared with no change in the TAU group. Outcomes were sustained six months after the intervention. There was statistically significant improvement in wake-after-sleep onset, sleep onset latency, and sleep efficiency, but not total sleep time. Actigraphy did not show statistically significant changes in sleep outcomes. CBT patients had reduced symptoms of fatigue, anxiety, and depression and increased physical and functional QOL compared to TAU patients.