Therapy May Help Cancer Patients Sleep Easier

Cancer patients with insomnia may benefit from cognitive behavioral therapy

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Matters of health can't always be separated clearly into physical issues and mental issues. A new review examined one such overlap between physical and mental health — sleeping troubles in cancer patients.

This review examined a number of different studies involving treatment of insomnia in cancer patients and survivors.

The review found that cognitive behavioral therapy seemed to be effective in treating insomnia in people with cancer.

"Talk to a therapist if you're having trouble sleeping."

According to the authors of this review, which was led by Sheila N. Garland, PhD, of the Department of Family Medicine and Community Health at the University of Pennsylvania in Philadelphia, sleep conditions like insomnia affect cancer patients more frequently than the general public.

"These problems can be a consequence of the psychological, behavioral, and physical effects of a cancer diagnosis and treatment," explained Dr. Garland and team. "The recommended first-line treatment for insomnia is cognitive behavioral therapy for insomnia (CBT-I), a non-pharmacological treatment that incorporates cognitive and behavior-change techniques and targets dysfunctional attitudes, beliefs, and habits involving sleep."

To examine how effective CBT-I might be for cancer patients, the researchers performed a review of studies involving cancer patients or survivors, insomnia and CBT. In total, 12 such studies were examined.

The analysis of the studies seemed to suggest that CBT-I was effective at treating the cancer patients' insomnia.

For example, Dr. Garland and team noted that in one study of 10 female breast cancer patients, only half of the participants were initially considered "good sleepers." However, that number increased to 71 percent after six months of CBT-I.

In a much larger study of 150 cancer patients, those receiving CBT-I were able to reduce their time spent awake during the night by about one hour after five weeks of treatment, compared to no change in overnight time awake in the group not receiving CBT-I.

In one year-long study of 57 breast cancer survivors receiving CBT-I, 70 percent of the participants saw a significant improvement in sleep quantity and sleep quality.

"Results suggest that CBT-I is associated with statistically and clinically significant improvements in subjective sleep outcomes in patients with cancer," concluded Dr. Garland and team. "CBT-I may also improve mood, fatigue, and overall quality of life, and can be successfully delivered through a variety of treatment modalities, making it possible to reach a broader range of patients who may not have access to more traditional programs."

In an interview with dailyRx News, Charlotte Howard, PhD, licensed psychologist based in Austin, Texas, said there are many steps that people, cancer patient or not, can take on their own to help themselves get better rest.

"To prepare for sleep, people can turn down the lights at least 30 minutes before sleep and help the body go from warmer to cooler (such as by taking a warm bath). Our bodies are programmed evolutionarily to respond to light and temperature change in terms of when to fall asleep," Dr. Howard said.

"To sleep more deeply, people must avoid alcohol, television and computers before sleep because all of them stimulate the brain in a way that makes deep sleep more difficult to reach," Dr. Howard told dailyRx News. 

"Talking to one's unconscious before falling asleep is also helpful," suggested Dr. Howard. "A person might say: 'You can put aside all your worries until the morning and sleep soundly, deeply and safely until then.'

"This method works in a way similar to when a person thinks about needing to wake up for an early flight and wakes up 5 minutes before the alarm even though that is hours before the usual time," she explained. "The unconscious tracked, even while the person slept, the information communicated to it before sleeping about when to awake."

This review was published online June 18 in Neuropsychiatric Disease and Treatment. No conflicts of interest were reported. 

Review Date: 
June 20, 2014
Last Updated:
June 25, 2014