2.50
Hdl Handle:
http://hdl.handle.net/10755/158288
Type:
Presentation
Title:
Overview of an Insomnia Intervention Study for Breast Cancer Survivors
Abstract:
Overview of an Insomnia Intervention Study for Breast Cancer Survivors
Conference Sponsor:Western Institute of Nursing
Conference Year:2003
Author:Epstein, Dana
P.I. Institution Name:Tucson VAMC
Contact Address:, Tucson, AZ, USA
Contact Telephone:602.277.5551
Co-Authors:Dirksen, Shannon R.
Insomnia is the most common sleep disorder in the general population and in persons with cancer. Breast cancer survivors (BCS) appear particularly vulnerable to sleep difficulty. It is estimated that 51% of women treated for breast cancer have current insomnia symptoms. Women with breast cancer appear to have twice the risk of developing clinically significant insomnia, yet there is a paucity of intervention studies addressing this health problem in cancer populations. The purpose of the study is to pilot test the feasibility of behavior therapy (BT) (attendance, attrition, treatment adherence, participant evaluation of treatment) and the efficacy of BT for reducing insomnia in BCS. In addition, we will explore the impact of treatment on fatigue, mood, and quality of life. The behavioral treatment of insomnia is based on learning theory. Ineffective strategies, poor sleep habits, and dysfunctional cognitions play a role in the maintenance of insomnia as a learned behavior. These perpetuating factors become the target of intervention as BCS with insomnia are taught: (a) to reassociate the bed and bedroom with cues for sleepiness; (b) to restrict amount of time spent awake in bed thereby consolidating sleep; and (c) to establish good sleep practices through sleep hygiene and basic sleep education. Insomnia may be primary or secondary (co-morbid) in nature and acute or chronic in duration. In this study, BCS with primary or secondary, acute or chronic insomnia are eligible to participate. A 2 (group) X 2 (measurement phase) factorial design will be used. A power analysis indicated 64 subjects are needed to meet the study aims. Breast cancer survivors will be blocked on insomnia type (primary or secondary) and randomly assigned within each insomnia type to either behavior therapy or a contact control group. Women, 18 years and older, with breast cancer who are at least 3 months post completion of primary cancer treatment and without active disease are eligible. Persons will be considered for inclusion if they meet the study definition of insomnia. Exclusion criteria include cognitive impairment or suspicion of sleep disorders other than insomnia. Subjects will complete pre- and post-treatment instruments to measure sleep quality, fatigue, mood, and quality of life. Sleep is measured in the pre and post-treatment phases through the completion of daily sleep diaries and by wearing wrist actigraphs. Significant others will also validate the insomnia problem. The behavioral treatment group receives a multi-component intervention consisting of stimulus control instructions, sleep restriction therapy, and sleep education and hygiene. The contact control group receives sleep education and hygiene only. Six weeks of treatment is comprised of 4 weekly classes and 2 weekly telephone sessions. Although insomnia is prevalent, sleep difficulty among cancer patients has received minimal treatment attention other than pharmacological intervention. Multiple factors are associated with the development of insomnia in BCS and must be considered in BT testing. We anticipate that the success of a feasibility pilot test will guide a future study to evaluate efficacy and the effect of the intervention on survival quality and co-morbidities among BCS.
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.titleOverview of an Insomnia Intervention Study for Breast Cancer Survivorsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158288-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Overview of an Insomnia Intervention Study 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">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Epstein, Dana</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Tucson VAMC</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Tucson, AZ, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">602.277.5551</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">Dirksen, Shannon R. </td></tr><tr><td colspan="2" class="item-abstract">Insomnia is the most common sleep disorder in the general population and in persons with cancer. Breast cancer survivors (BCS) appear particularly vulnerable to sleep difficulty. It is estimated that 51% of women treated for breast cancer have current insomnia symptoms. Women with breast cancer appear to have twice the risk of developing clinically significant insomnia, yet there is a paucity of intervention studies addressing this health problem in cancer populations. The purpose of the study is to pilot test the feasibility of behavior therapy (BT) (attendance, attrition, treatment adherence, participant evaluation of treatment) and the efficacy of BT for reducing insomnia in BCS. In addition, we will explore the impact of treatment on fatigue, mood, and quality of life. The behavioral treatment of insomnia is based on learning theory. Ineffective strategies, poor sleep habits, and dysfunctional cognitions play a role in the maintenance of insomnia as a learned behavior. These perpetuating factors become the target of intervention as BCS with insomnia are taught: (a) to reassociate the bed and bedroom with cues for sleepiness; (b) to restrict amount of time spent awake in bed thereby consolidating sleep; and (c) to establish good sleep practices through sleep hygiene and basic sleep education. Insomnia may be primary or secondary (co-morbid) in nature and acute or chronic in duration. In this study, BCS with primary or secondary, acute or chronic insomnia are eligible to participate. A 2 (group) X 2 (measurement phase) factorial design will be used. A power analysis indicated 64 subjects are needed to meet the study aims. Breast cancer survivors will be blocked on insomnia type (primary or secondary) and randomly assigned within each insomnia type to either behavior therapy or a contact control group. Women, 18 years and older, with breast cancer who are at least 3 months post completion of primary cancer treatment and without active disease are eligible. Persons will be considered for inclusion if they meet the study definition of insomnia. Exclusion criteria include cognitive impairment or suspicion of sleep disorders other than insomnia. Subjects will complete pre- and post-treatment instruments to measure sleep quality, fatigue, mood, and quality of life. Sleep is measured in the pre and post-treatment phases through the completion of daily sleep diaries and by wearing wrist actigraphs. Significant others will also validate the insomnia problem. The behavioral treatment group receives a multi-component intervention consisting of stimulus control instructions, sleep restriction therapy, and sleep education and hygiene. The contact control group receives sleep education and hygiene only. Six weeks of treatment is comprised of 4 weekly classes and 2 weekly telephone sessions. Although insomnia is prevalent, sleep difficulty among cancer patients has received minimal treatment attention other than pharmacological intervention. Multiple factors are associated with the development of insomnia in BCS and must be considered in BT testing. We anticipate that the success of a feasibility pilot test will guide a future study to evaluate efficacy and the effect of the intervention on survival quality and co-morbidities among BCS. </td></tr></table>en_GB
dc.date.available2011-10-26T20:41:47Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:41:47Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.