Nav: Home

Online program improves insomnia in adolescent and young adult cancer survivors

June 22, 2020

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."
-end-
Support for the study was provided by a Psychosocial Launch Grant from Alex's Lemonade Stand Foundation.

Dana-Farber Cancer Institute

Related Cancer Articles:

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.
Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.
Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.
Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.
Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.
More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.
New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.
American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.
Oncotarget: Cancer pioneer employs physics to approach cancer in last research article
In the cover article of Tuesday's issue of Oncotarget, James Frost, MD, PhD, Kenneth Pienta, MD, and the late Donald Coffey, Ph.D., use a theory of physical and biophysical symmetry to derive a new conceptualization of cancer.
More Cancer News and Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Debbie Millman: Designing Our Lives
From prehistoric cave art to today's social media feeds, to design is to be human. This hour, designer Debbie Millman guides us through a world made and remade–and helps us design our own paths.
Now Playing: Science for the People

#574 State of the Heart
This week we focus on heart disease, heart failure, what blood pressure is and why it's bad when it's high. Host Rachelle Saunders talks with physician, clinical researcher, and writer Haider Warraich about his book "State of the Heart: Exploring the History, Science, and Future of Cardiac Disease" and the ails of our hearts.
Now Playing: Radiolab

Insomnia Line
Coronasomnia is a not-so-surprising side-effect of the global pandemic. More and more of us are having trouble falling asleep. We wanted to find a way to get inside that nighttime world, to see why people are awake and what they are thinking about. So what'd Radiolab decide to do?  Open up the phone lines and talk to you. We created an insomnia hotline and on this week's experimental episode, we stayed up all night, taking hundreds of calls, spilling secrets, and at long last, watching the sunrise peek through.   This episode was produced by Lulu Miller with Rachael Cusick, Tracie Hunte, Tobin Low, Sarah Qari, Molly Webster, Pat Walters, Shima Oliaee, and Jonny Moens. Want more Radiolab in your life? Sign up for our newsletter! We share our latest favorites: articles, tv shows, funny Youtube videos, chocolate chip cookie recipes, and more. Support Radiolab by becoming a member today at Radiolab.org/donate.