2.50
Hdl Handle:
http://hdl.handle.net/10755/158164
Type:
Presentation
Title:
Insomnia Intervention for Breast Cancer Survivors
Abstract:
Insomnia Intervention for Breast Cancer Survivors
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:Epstein, Dana, PhD, RN
P.I. Institution Name:Dept. of Veterans Affairs, Carl. T. Hayden Medical Center, R&D Dept. ERS/151
Title:Associate Chief Nurse for Research
Co-Authors:Shannon R. Dirksen
Introduction: Insomnia is the most common sleep disorder in both the general population and persons with cancer. Survivors of breast cancer appear particularly vulnerable to sleep difficulty. Fifty-one percent of women treated for breast cancer report insomnia symptoms and 19% meet diagnostic criteria for clinical insomnia (Savard et al., 2001). Insomnia among breast cancer survivors (BCS) has received minimal treatment attention other than phar macological intervention. Purpose: The purpose of this presentation is to demonstrate the efficacy of cognitive-behavioral treatment for reducing insomnia in BCS. Methods: Women, 18 years and older, with breast cancer who were at least 3 months post completion of primary cancer treatment and without active disease were eligible to participate. Women were considered for inclusion if they met the study definition of insomnia. Exclusion criteria included cognitive impairment or suspicion of sleep disorders other than insomnia. A 2 (group) X 2 (measurement phase) factorial design was used. Breast cancer survivors were randomly assigned to either theory-driven multi-component intervention (MCI) (stimulus control instructions, sleep restriction therapy, sleep education and hygiene) or a component comparison group (CC) (sleep education and hygiene). Daily sleep diaries (DSD) and the Insomnia Severity Index (ISI) (Bastien et al., 2001) were used to ascertain the outcomes in this report. The DSD and ISI are used in research and clinical settings to detect the severity and impact of insomnia. Results: Seventy-two women completed treatment. The participants had a mean age of 58.2 years (SD=10.3), were 4.8 years (SD=5.8) post primary cancer treatment, and had a mean insomnia duration of 5.2 years (SD=6.7). Within-group and between-group differences on the DSD reported variables of sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TIB), sleep efficiency (SE), and sleep quality (QUAL), and the ISI scores were examined using repeated measures analysis of variance and planned comparisons. The two groups were equivalent at baseline on all outcome measures. There were significant main effects of time for all sleep diary variables and the ISI variable (ps< .001). There were significant group X time interactions for TIB and QUAL (ps< .05). Subjects in both groups improved for all sleep diary and ISI outcomes. The MCI group spent significantly less time in bed but had poorer sleep quality at post-treatment than the CC group. Conclusions: Multi-component cognitive-behavioral intervention is a promising non-pharmacological alternative for improving sleep in BCS. The sleep of the MCI group became more consolidated as a result of treatment. The component comparison treatment was also effective in reducing insomnia. The ISI revealed improvement in the sleep of BCS. The ISI findings parallel the improvement shown for the sleep diary outcomes. Possible explanations for the improvement in both groups will be discussed. The clinical significance of the findings will be examined.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleInsomnia Intervention for Breast Cancer Survivorsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158164-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Insomnia Intervention for Breast Cancer Survivors</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Epstein, Dana, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Dept. of Veterans Affairs, Carl. T. Hayden Medical Center, R&amp;D Dept. ERS/151</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Chief Nurse for Research</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dana.epstein@med.va.gov</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Shannon R. Dirksen</td></tr><tr><td colspan="2" class="item-abstract">Introduction: Insomnia is the most common sleep disorder in both the general population and persons with cancer. Survivors of breast cancer appear particularly vulnerable to sleep difficulty. Fifty-one percent of women treated for breast cancer report insomnia symptoms and 19% meet diagnostic criteria for clinical insomnia (Savard et al., 2001). Insomnia among breast cancer survivors (BCS) has received minimal treatment attention other than phar macological intervention. Purpose: The purpose of this presentation is to demonstrate the efficacy of cognitive-behavioral treatment for reducing insomnia in BCS. Methods: Women, 18 years and older, with breast cancer who were at least 3 months post completion of primary cancer treatment and without active disease were eligible to participate. Women were considered for inclusion if they met the study definition of insomnia. Exclusion criteria included cognitive impairment or suspicion of sleep disorders other than insomnia. A 2 (group) X 2 (measurement phase) factorial design was used. Breast cancer survivors were randomly assigned to either theory-driven multi-component intervention (MCI) (stimulus control instructions, sleep restriction therapy, sleep education and hygiene) or a component comparison group (CC) (sleep education and hygiene). Daily sleep diaries (DSD) and the Insomnia Severity Index (ISI) (Bastien et al., 2001) were used to ascertain the outcomes in this report. The DSD and ISI are used in research and clinical settings to detect the severity and impact of insomnia. Results: Seventy-two women completed treatment. The participants had a mean age of 58.2 years (SD=10.3), were 4.8 years (SD=5.8) post primary cancer treatment, and had a mean insomnia duration of 5.2 years (SD=6.7). Within-group and between-group differences on the DSD reported variables of sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TIB), sleep efficiency (SE), and sleep quality (QUAL), and the ISI scores were examined using repeated measures analysis of variance and planned comparisons. The two groups were equivalent at baseline on all outcome measures. There were significant main effects of time for all sleep diary variables and the ISI variable (ps&lt; .001). There were significant group X time interactions for TIB and QUAL (ps&lt; .05). Subjects in both groups improved for all sleep diary and ISI outcomes. The MCI group spent significantly less time in bed but had poorer sleep quality at post-treatment than the CC group. Conclusions: Multi-component cognitive-behavioral intervention is a promising non-pharmacological alternative for improving sleep in BCS. The sleep of the MCI group became more consolidated as a result of treatment. The component comparison treatment was also effective in reducing insomnia. The ISI revealed improvement in the sleep of BCS. The ISI findings parallel the improvement shown for the sleep diary outcomes. Possible explanations for the improvement in both groups will be discussed. The clinical significance of the findings will be examined.</td></tr></table>en_GB
dc.date.available2011-10-26T20:34:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:34:23Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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