Online Program Shown to Improve Insomnia, QOL in Adolescents and Young Adult Cancer Survivors

An online program designed specifically for adolescents and young adults (AYA) who survived cancer was shown to significantly alleviate insomnia and improve overall quality of life (QOL), according to study findings published today in Pediatric Blood and Cancer.

Although the current gold standard for treatment of insomnia is cognitive‐behavioral therapy for insomnia (CBT-I), this was designed for adults and may not be applicable to AYA who have different medical, psychosocial, and developmental needs.

"People who survived cancer as adolescents or young adults face a variety of sleep-related issues unique to their age group," said study author Eric Zhou, PhD, staff psychologist at the Dana-Farber Cancer Institute. “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.”

Zhou and Dana-Farber Cancer Institute colleague Christopher Recklitis, PhD, MPH, sought to examine a novel online CBT-I program specifically tailored to AYA cancer survivors. The program, known as SHUTi (Sleep Healthy Using the Internet), consisted of six 20- to 30-minute sessions characterized by text, images, and video that explained how insomnia develops and how it can be overcome.

"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," said Zhou.

Notably, the researchers adapted SHUTi’s brief stories of individuals struggling with insomnia to ones more relatable to young people. They recruited 22 AYA cancer survivors with insomnia (mean age, 20.4 years; range, 14‐25; 9.7 years post diagnosis), of which 54.5% were blood cancer survivors and 45.5% were solid tumor survivors. Sleep health, fatigue, and QOL were assessed at baseline and at 8 and 16 weeks post baseline.

Although most participants (72.7%) did not complete all 6 study sessions, significant improvements were observed in insomnia severity, daytime sleepiness, fatigue, and QOL at both postbaseline measures. Moreover, those who completed at least 2 sessions were shown to have reported better sleep via insomnia severity index total score than those who did not.

"Notably, our participants' insomnia severity continued to get better after the intervention had ended, suggesting that they continued to make sleep-related decisions that helped their sleep even after they had finished using the program," concluded Recklitis.

Reference

Zhou ES, Recklitis CJ. Internet‐delivered insomnia intervention improves sleep and quality of life for adolescent and young adult cancer survivors. Pediatr Blood Cancer. Published online June 22, 2020. doi:10.1002/pbc.28506