Moderators of Treatment Effects of a Video-Based Cognitive-Behavioral Therapy for Insomnia Comorbid With Cancer

ABSTRACT

Purpose. To assess the moderating role of demographic and clinical variables on the efficacy of a video-based cognitive behavioral therapy for insomnia (VCBT-I) among breast cancer patients. Patients and methods. As part of a randomized controlled trial, 80 women received VCBT-I. Results. Patients with a more advanced breast cancer were less likely to show reductions on the Insomnia Severity Index (ISI) and increased sleep efficiency at posttreatment. Patients using an antidepressant medication showed a larger reduction of ISI scores and a higher rate of insomnia remission. Remission of insomnia was also significantly more likely in individuals with a higher annual income. When using a multivariate binary classification tree analysis, the best and unique predictor of insomnia remission was having a less severe baseline ISI score. Conclusion. Although efficacious in general, VCBT-I does not appear to be an optimal format for everybody.

Acknowledgments

We sincerely thank the patients for their participation in this study and Fred Sengmueller for revising the manuscript.

Additional information

Funding

This research was funded by the Canadian Breast Cancer Research Alliance (grant #017738) and a research scientist award from the Fonds de la recherche en santé du Québec to the first author.