Online program improves insomnia in adolescent and young adult cancer survivors

Date:
June 22, 2020
Source:
Dana-Farber Cancer Institute
Summary:
Researchers show that an online program developed specifically
for AYA cancer survivors can significantly alleviate insomnia and
improve overall quality of life.



FULL STORY ========================================================================== Adolescents and young adults (AYA) who have survived cancer often
continue to suffer from insomnia long after treatment ends, interfering
with a range of daily activities. In a study published today by Pediatric
Blood and Cancer, researchers at Dana-Farber Cancer Institute show that
an online program developed specifically for AYA cancer survivors can significantly alleviate insomnia and improve overall quality of life.


==========================================================================
The program, which consists of six, 20-30 minute sessions, shows how
sleep habits that may have helped patients cope with their intensive
cancer treatments can become obstacles to healthy sleep as survivors move beyond treatment. Its automated format makes it particularly well-suited
to the moment, as telehealth and online programs that are already adopted
by many hospitals and clinics, are becoming even more widely used as a
result of the COVID-19 crisis.

"Cognitive-behavioral therapy for insomnia (CBT-I), which helps patients understand the behavioral and thought patterns that lead to long-term
troubles with falling or staying asleep, has been shown to be very
effective in adult cancer survivors. However, it has not been widely
tested in the AYA survivor group. We wanted to explore whether a CBT-I
program, specifically tailored to AYA survivors and available online,
could be helpful in this population," said Eric Zhou, PhD, who conducted
the study with Dana-Farber colleague Christopher Recklitis, PhD, MPH.

"People who survived cancer as adolescents or young adults face a variety
of sleep-related issues unique to their age group," Zhou commented. "These include the constraints placed on young people's sleep schedules by their parents or disruptive roommates. Teens and young adults also undergo
normal developmental changes in circadian timing, naturally going to bed
later and sleeping later than younger children and older adults. Insomnia treatments for AYA cancer survivors need to take account of these factors,
as well as addressing their long-term cancer-related issues such as pain
or fatigue." The insomnia intervention tested in the study is known as
SHUTi (Sleep Healthy Using the Internet) was developed by researchers at
the University of Virginia and adapted for AYA cancer survivors by Zhou
and Recklitis. The interactive program uses text, images, and video to
explain how insomnia develops and how it can be overcome. In adapting the program, Dana-Farber researchers replaced vignettes -- brief stories of individuals struggling with insomnia -- from the original version with
ones more relatable to young people.

The program discusses how sleep behaviors that helped patients weather
cancer treatment can become maladaptive when they return to normal
life. "During treatment, people may stay in bed because they're not
feeling well or haven't gotten enough sleep. They may take naps and
their sleep at night can be fragmented," said Zhou. As people move
into recovery, these habits can make it difficult to resume healthy
sleep patterns.

"SHUTi trains people to recalibrate their sleep so their sleep habits
are no longer addressing the problems they experienced during treatment
and are, instead, focused on improving long-term sleep," Zhou remarked.

In the study, 22 AYA cancer survivors -- mean age 20.4 years -- with
insomnia enrolled to use the specially adapted SHUTi. As part of the
program, participants kept a sleep diary, tracking when they slept,
and entered the information into SHUTi, which adjusted its sleep recommendations accordingly.

At eight and 16 weeks after starting to use SHUTi, participants reported
a significant lessening in insomnia severity, daytime sleepiness, and
fatigue, and an overall improvement in quality of life.

"Our results demonstrate that an internet-delivered CBT-I program
targeting AYA cancer survivors reduced their insomnia and improved
their quality of life," Recklitis remarked. "Notably, our participants' insomnia severity continued to get better after the intervention had
ended, suggesting that the continued to make sleep-related decisions
that helped their sleep even after they had finished using the program." Support for the study was provided by a Psychosocial Launch Grant from
Alex's Lemonade Stand Foundation.


========================================================================== Story Source: Materials provided by Dana-Farber_Cancer_Institute. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Eric S. Zhou, Christopher J. Recklitis. Internet-delivered insomnia
intervention improves sleep and quality of life for adolescent
and young adult cancer survivors. Pediatric Blood & Cancer, 2020;
e28506 DOI: 10.1002/pbc.28506 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/06/200622095037.htm

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