TY - JOUR
T1 - The Survivorship Sleep Program (SSP)
T2 - A synchronous, virtual cognitive behavioral therapy for insomnia pilot program among cancer survivors
AU - Hall, Daniel L.
AU - Arditte Hall, Kimberly A.
AU - Gorman, Mark J.
AU - Comander, Amy
AU - Goldstein, Michael R.
AU - Cunningham, Tony J.
AU - Wieman, Sarah
AU - Mizrach, Helen R.
AU - Juhel, Brooke C.
AU - Li, Raissa
AU - Markowitz, Alexandros
AU - Grandner, Michael
AU - Park, Elyse R.
N1 - Funding Information: This work was conducted with support from the American Cancer Society (Massachusetts General Hospital Institutional Research Grant). Daniel L. Hall was funded by the National Center for Complementary and Integrative Health (grant K23AT010157), and Elyse R. Park was funded by the National Cancer Institute (grant K24CA197382). During data collection, Michael R. Goldstein and Tony J. Cunningham were funded by the National Heart, Lung, and Blood Institute Research Training Program in Sleep, Circadian, and Respiratory Neurobiology (grant T32HL007901) through the Division of Sleep Medicine at Harvard Medical School and Brigham and Women's Hospital. Publisher Copyright: © 2021 American Cancer Society
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Background: For cancer survivors, insomnia is prevalent, distressing, and persists for years if unmanaged. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment yet can be difficult to access and may require modification to address survivorship-specific barriers to sleep. In this 2-phase study, the authors adapted and assessed the feasibility, acceptability, and preliminary effects of synchronous, virtual CBT-I adapted for cancer survivors (the Survivorship Sleep Program [SSP]). Methods: From April to August 2020, cancer survivors with insomnia (N = 10) were interviewed to refine SSP content and delivery. From October 2020 to March 2021, 40 survivors were recruited for a randomized controlled trial comparing 4 weekly SSP sessions with enhanced usual care (EUC) (CBT-I referral plus a sleep hygiene handout). Feasibility and acceptability were assessed by enrollment, retention, attendance, fidelity, survey ratings, and exit interviews. Insomnia severity (secondary outcome), sleep quality, sleep diaries, and fatigue were assessed at baseline, postintervention, and at 1-month follow-up using linear mixed models. Results: The SSP included targeted content and clinician-led, virtual delivery to enhance patient centeredness and access. Benchmarks were met for enrollment (56% enrolled/eligible), retention (SSP, 90%; EUC, 95%), attendance (100%), and fidelity (95%). Compared with EUC, the SSP resulted in large, clinically significant improvements in insomnia severity (Cohen d = 1.19) that were sustained at 1-month follow-up (Cohen d = 1.27). Improvements were observed for all other sleep metrics except sleep diary total sleep time and fatigue. Conclusions: Synchronous, virtually delivered CBT-I targeted to cancer survivors is feasible, acceptable, and seems to be efficacious for reducing insomnia severity. Further testing in larger and more diverse samples is warranted.
AB - Background: For cancer survivors, insomnia is prevalent, distressing, and persists for years if unmanaged. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment yet can be difficult to access and may require modification to address survivorship-specific barriers to sleep. In this 2-phase study, the authors adapted and assessed the feasibility, acceptability, and preliminary effects of synchronous, virtual CBT-I adapted for cancer survivors (the Survivorship Sleep Program [SSP]). Methods: From April to August 2020, cancer survivors with insomnia (N = 10) were interviewed to refine SSP content and delivery. From October 2020 to March 2021, 40 survivors were recruited for a randomized controlled trial comparing 4 weekly SSP sessions with enhanced usual care (EUC) (CBT-I referral plus a sleep hygiene handout). Feasibility and acceptability were assessed by enrollment, retention, attendance, fidelity, survey ratings, and exit interviews. Insomnia severity (secondary outcome), sleep quality, sleep diaries, and fatigue were assessed at baseline, postintervention, and at 1-month follow-up using linear mixed models. Results: The SSP included targeted content and clinician-led, virtual delivery to enhance patient centeredness and access. Benchmarks were met for enrollment (56% enrolled/eligible), retention (SSP, 90%; EUC, 95%), attendance (100%), and fidelity (95%). Compared with EUC, the SSP resulted in large, clinically significant improvements in insomnia severity (Cohen d = 1.19) that were sustained at 1-month follow-up (Cohen d = 1.27). Improvements were observed for all other sleep metrics except sleep diary total sleep time and fatigue. Conclusions: Synchronous, virtually delivered CBT-I targeted to cancer survivors is feasible, acceptable, and seems to be efficacious for reducing insomnia severity. Further testing in larger and more diverse samples is warranted.
KW - cancer
KW - insomnia
KW - randomized controlled trial
KW - survivorship
KW - virtual interventions
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U2 - 10.1002/cncr.34066
DO - 10.1002/cncr.34066
M3 - Article
C2 - 34914845
SN - 0008-543X
VL - 128
SP - 1532
EP - 1544
JO - Cancer
JF - Cancer
IS - 7
ER -