Long-Term Effects of Two Formats of Cognitive Behavioral Therapy for Insomnia Comorbid with Breast Cancer.

TitleLong-Term Effects of Two Formats of Cognitive Behavioral Therapy for Insomnia Comorbid with Breast Cancer.
Publication TypeJournal Article
Year of Publication2016
AuteursSavard, J, Ivers, H, Savard, M-H, Morin, CM
JournalSleep
Volume39
Issue4
Pagination813-23
Date Published2016 Apr 01
ISSN1550-9109
KeywordsBreast Neoplasms, Cognitive Therapy, Female, Humans, Middle Aged, Pamphlets, Sleep, Sleep Initiation and Maintenance Disorders, Time Factors, Videotape Recording
Abstract

STUDY OBJECTIVES: The goal of this randomized controlled trial, conducted in breast cancer patients, was to assess the long-term efficacy of a video-based cognitive behavioral therapy for insomnia (VCBT-I), as compared to a professionally administered intervention (PCBT-I) and to a no-treatment group (CTL). An earlier report revealed that, at posttreatment, VCBT-I patients showed significantly greater sleep improvements than CTL, but that PCBT-I produced superior effects than VCBT-I on some sleep and secondary outcomes. In this report, long-term effects are compared.METHODS: Two hundred forty-two women with breast cancer and with insomnia symptoms or using hypnotic medications participated to this three-arm randomized controlled trial: (1) PCBT-I (n = 81); (2) VCBT-I (n = 80); or (3) no treatment (CTL; n = 81) group. PCBT-I was composed of six weekly, individual sessions of approximately 50 min, whereas VCBT-I comprised a 60-min animated video and six booklets.RESULTS: Study measures (sleep and secondary variables) were administered at pretreatment and posttreatment, and at a 3-, 6-, and 12-mo follow-up. Treatment gains were well sustained at follow-up in both PCBT-I and VCBT-I. As at posttreatment, the remission rate of insomnia at follow-up was greater in PCBT-I than in VCBT-I, which was greater than in CTL.CONCLUSIONS: Although face-to-face therapy remains the optimal format to efficaciously administer CBT for insomnia in cancer patients, a minimal intervention, such as the video-based intervention tested in this study, produces significant and sustainable treatment effects.CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT00674830.

DOI10.5665/sleep.5634
Alternate JournalSleep
PubMed ID26715229
PubMed Central IDPMC4791615