Initial evaluation of an Internet intervention to improve the sleep of cancer survivors with insomnia

TLDR

Insomnia is common among cancer survivors, and although CBT‑I is effective, it is rarely implemented because of limited availability. The study examined whether an easily accessible online CBT‑I program could improve insomnia symptoms in cancer survivors. Twenty‑eight survivors were randomized to an Internet CBT‑I program or a waitlist control; the program delivered core CBT‑I components and data were collected via online questionnaires and sleep diaries. Participants receiving the Internet intervention showed significant improvements in insomnia severity, sleep efficiency, latency, soundness, awakening quality, and fatigue, with effect sizes ranging from small to large across sleep, fatigue, depression, anxiety, and quality of life. © 2011 John Wiley & Sons, Ltd.

Abstract

Abstract Objective : Insomnia is a common complaint among cancer survivors. Fortunately, cognitive‐behavioral therapy for insomnia (CBT‐I) has been shown to be an effective treatment in this population. However, it is rarely implemented given its limited availability. To address this barrier, we examined the ability of an easily accessible online CBT‐I program to improve insomnia symptoms in cancer survivors. Methods : Twenty‐eight cancer survivors with insomnia were randomly assigned to either an Internet insomnia intervention ( n = 14) or to a waitlist control group ( n = 14). The online program, Sleep Healthy Using The Internet, delivers the primary components of CBT‐I (sleep restriction, stimulus control, cognitive restructuring, sleep hygiene, and relapse prevention). Pre‐ and post‐assessment data were collected via online questionnaires and daily sleep diaries. Results : Participants in the Internet group showed significant improvements at post‐assessment compared with those in the control group in overall insomnia severity ( F 1,26 = 22.8; p <0.001), sleep efficiency ( F 1,24 = 11.45; P = 0.002), sleep onset latency ( F 1,24 = 5.18; P = 0.03), soundness of sleep ( F 1,24 = 9.34; P = 0.005), restored feeling upon awakening ( F 1,24 = 11.95; P = 0.002), and general fatigue ( F 1,26 = 13.88; P = 0.001). Although other group × time interactions were not significant, overall adjusted effect sizes for all sleep variables as well as for fatigue, depression, anxiety, and quality of life ranged from small to large. Conclusions : CBT‐I delivered through an interactive, individually tailored Internet intervention may be a viable treatment option for cancer survivors experiencing insomnia. Copyright © 2011 John Wiley & Sons, Ltd.