Feasibility of a self-help treatment for insomnia comorbid with cancer

Objective: Professionally administered cognitive-behavioral therapy (CBT) is efficacious for treating insomnia in breast cancer survivors. However, given the limited accessibility to CBT for insomnia in cancer clinics, there is a need to develop other delivery formats for this intervention. This feasibility study examined patients' satisfaction with a self-help CBT for insomnia comorbid with cancer and gathered some preliminary data on its effect on sleep and associated features. Methods: Eleven breast cancer patients reporting insomnia symptoms received a 6-week intervention composed of a 60-min video using an animated cartoon format and 6 short booklets developed in French. Patients completed a semi-structured interview at post-treatment, a battery of self-report scales and a daily sleep diary (14 days) at pre- and post-treatment and at a 3-month follow-up. Results: At post-treatment interview, comments about the treatment material were uniformly positive. On a questionnaire, patients also reported to be satisfied with the treatment overall, with the video and the booklets' content, as well as with their sleep improvement at post-treatment (scores from 2.7 to 3.1; scale from 0 to 4). From pre- to post-treatment, moderate-to-large effect sizes and statistically and clinically significant differences were found on most sleep variables, as well as overall quality of life. These therapeutic gains were well sustained at a 3-month follow-up. Conclusions: Patients were satisfied with the treatment received. Although it is too early to draw any firm conclusion, treatment outcomes suggest a potential for integration into routine cancer care as a first-line sleep management intervention. Copyright (C) 2010 John Wiley & Sons, Ltd.