Feasibility of a Preventive Intervention for Insomnia in Women with Breast Cancer Receiving Chemotherapy

ABSTRACT

Objective/Background: Breast cancer patients display high rates of insomnia and chemotherapy treatments appear to contribute significantly to the development of sleep disturbances among this population. The efficacy of cognitive-behavioral therapy for insomnia (CBT-I) is now well established for treating insomnia comorbid with cancer but is not widely accessible and is also fairly costly. Its capacity to prevent the onset of insomnia symptoms in cancer patients who are at a high risk of developing these difficulties remains to be demonstrated. The purpose of this study was to assess the feasibility of a brief self-administered preventive intervention of insomnia in breast cancer patients about to undergo chemotherapy.

Participants/Methods: A sample of 20 women with breast cancer and with no insomnia were recruited and received the preventive intervention, taking the form of a short booklet, at their first chemotherapy treatment. One month later, a semi-structured phone interview was conducted to assess their satisfaction with different aspects of the booklet (e.g., format, content) and their adherence to the proposed strategies and to collect qualitative information. A 3-month follow-up evaluation was also conducted.

Results: Patients reported a higher level of satisfaction than expected (mean score corresponding to “a lot” on the scale) and a moderate level of adherence falling only slightly under the hypothesized level. The open comments collected corroborated the good acceptability of this minimal preventive CBT-I in breast cancer patients initiating chemotherapy.

Conclusions: Overall, findings of this study confirm that a self-administered preventive intervention for insomnia is feasible and a promising approach in breast cancer patients about to initiate chemotherapy.

Acknowledgments

We wish to acknowledge the important contribution of Julie Tremblay-Roy, Marie-Hélène Savard, Marie Solange Bernatchez, Eugénie Simard, Véronique Roy and Catherine Poveda-Perdomo who were involved in the recruitment and assessment of the participants, the data entry and the study coordination, as well as the participants who volunteered their time for this study. We also sincerely thank the experts’ committee composed of Charles M. Morin, Marie-Hélène Savard, Simon Beaulieu-Bonneau, Aude Caplette-Gingras, Lucie Casault and Marie-Christine Ouellet who had a significant contribution in the development of the self-administered preventive intervention for insomnia tested in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by a grant from the Fonds de recherche Québec – Société et culture (2017-SE-196496).