Cancer patients plagued with sleep troubles find insomnia and disturbed sleep can interfere with their therapeutic and supportive care measures. So it’s imperative that doctors offer patients reliable and effective interventions. It’s estimated that almost half of all cancer patients have sleeping problems. In large part, the trouble stems from pain and/or side effects of treatment. And such problems are best dealt with on an individual basis.
While it’s true that there are effective drugs that can help insomnia, many cancer patients don’t want to take additional medications—either because they have concerns about additional side effects or because they are afraid of developing a dependence on medication(s). There are two behavior interventions offered to help get sleep relief, and we can look at the latest findings relating to each of them.
The so called “gold standard” treatment is called cognitive behavioral therapy or CBT-I while the newer intervention is known as Mindfuness-Based Stress Reduction or MBSR. CBT is a psychotherapeutic approach that deals with dysfunctional emotions and maladaptive behaviors. Most therapists work with patients to allay anxiety and depression and these are problems that cannot be controlled through rational thought. It is effective to treat a variety of conditions—such as mood, anxiety, personality eating, substance abuce, tic and psychotic disorders. The therapist helps the patient deal with the “here and now’ to alleviate both the symptoms and the patient’s vulnerability.
MBSR, the second intervention, evolved into a complementary medicine that addresses a variety of health problems. Proponents say it brings together mindfulness meditation and yoga. It generally involved an 8-week intensive training in medication tries to produce a greater awareness of underlying emotiona, physical and spiritual health. The MBSR program started at the University of Massachusetts Medical Center in 1979 and is now offered in over 200 medical centers, hospitals and clinics around the world.
A new study just completed by researchers associated with the University of Pennsylvania found that both CBT-I and MBSR dramatically reduced insomnia and sleep deprivation. Their research involved 111 cancer patients recruited from a cancer center in Calgary, Alberta, Canada, to one of two randomly assigned interventions for their insomnia, either CBT-I (47) or MBSR (64). When assessed 3 months after completing an 8-week treatment protocol, researches found that both CBY-I and MBSR reduced insomnia across each group. However, the effects in the CBT-I group occurred more rapidly whereas the MBSR group tended to show more gradual improvement over time.
The conclusion the scientists reached suggests we should not apply a one size fits all model to the treatment of insomnia and stresses the need to individualize treatment based on the patient’s characteristics and preferences.
Details can be found online in the current Journal of Clinical Oncology.