Dickerson Suzanne S, Kwon Misol, Wilding Gregory E, Zhu Jingtao
University at Buffalo School of Nursing, The State University of New York, 301E Wende Hall, 3435 Main St, Buffalo, NY, 14214, USA.
Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
J Cancer Surviv. 2024 Nov 26. doi: 10.1007/s11764-024-01704-1.
To determine the efficacy of nurse-delivered brief behavioral treatment for insomnia (BBTI) compared to an attention control, in a heterogeneous sample of cancer survivors to reduce insomnia symptom severity.
We recruited 132 participants from cancer care clinics, who had an Insomnia Severity Index (ISI) score ≥ 8. Participants were randomized into two groups: an experimental BBTI group and a healthy eating attention control group. Demographics survey at baseline, and sleep-related questionnaires, self-reported sleep diaries, and wrist-worn actigraphy at baseline, 1, 3, and 12 months were collected. Statistical analyses used analysis of covariance (ANCOVA) models with two-sided 0.05 nominal significance level for treatment effect for primary outcome of insomnia severity at 1 month.
Participants were cancer survivors with a mean age of 63.7 years, 55% female, 88.6% white, with breast, prostate, colorectal, and lung cancer. Statistically significant group differences were observed at all time points for ISI and sleep quality (ISI effect sizes 0.56, 0.59, and 0.54 respectively). Additionally, at 1 month, those in insomnia remission (ISI ≤ 8) were higher for the BBTI (55.1%) compared to the control group (43.3%). Secondary outcomes from sleep diary measures (i.e., sleep efficiency, sleep onset latency, wake after sleep onset) were significant at 1 month.
The BBTI group was significantly effective in reducing insomnia severity and improving sleep quality over time compared to the control among cancer survivors.
Clinical trials identifier: http://ClinicalTrials.gov , NCT03810365.
Implementing BBTI in survivorship settings can effectively address and manage insomnia symptoms, thus bridging a crucial gap in care for cancer survivors.
在癌症幸存者的异质性样本中，确定与注意力对照组相比，护士提供的失眠简短行为治疗（BBTI）减轻失眠症状严重程度的疗效。
我们从癌症护理诊所招募了132名失眠严重程度指数（ISI）评分≥8的参与者。参与者被随机分为两组：实验性BBTI组和健康饮食注意力对照组。收集基线时的人口统计学调查问卷，以及基线、1个月、3个月和12个月时的睡眠相关问卷、自我报告的睡眠日记和腕部活动记录仪数据。统计分析采用协方差分析（ANCOVA）模型，对1个月时失眠严重程度这一主要结局的治疗效果采用双侧名义显著性水平0.05。
参与者为癌症幸存者，平均年龄63.7岁，55%为女性，88.6%为白人，患有乳腺癌、前列腺癌、结直肠癌和肺癌。在ISI和睡眠质量的所有时间点均观察到统计学上的显著组间差异（ISI效应大小分别为0.56、0.59和0.54）。此外，在1个月时，BBTI组失眠缓解（ISI≤8）的比例（55.1%）高于对照组（43.3%）。睡眠日记测量的次要结局（即睡眠效率、入睡潜伏期、睡眠中觉醒）在1个月时具有显著性。
与对照组相比，BBTI组在随着时间推移减轻癌症幸存者的失眠严重程度和改善睡眠质量方面具有显著效果。
临床试验标识符：http://ClinicalTrials.gov ，NCT03810365。
在癌症幸存者护理中实施BBTI可以有效解决和管理失眠症状，从而弥补癌症幸存者护理中的关键差距。
