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Feasibility of a video-based cognitive behavioral therapy for insomnia in French adult cancer outpatients: results from the Sleep-4-All-1 study

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Abstract

Background

Insomnia affects up to 63% of patients with cancer. Cognitive behavioral therapy for insomnia (CBT-I) is considered to be the non-pharmacological gold standard treatment, but it remains underutilized in France. Self-administered interventions offer new ways to overcome some of the barriers that restrict access to efficacious supportive care.

Objective

To assess the feasibility, among French adult cancer outpatients, of a validated Quebec video-based, self-administered, cognitive behavioral therapy for insomnia (VCBT-I).

Methods

A pre-post design with quantitative measures (Insomnia Severity Index, Edmonton Symptom Assessment System, Treatment Perception Questionnaire) and qualitative measures (semi-structured interviews) was used.

Results

One hundred and seventy-three cancer outpatients were self-screened for insomnia, and 57% (n=99) reported significant symptoms. Among them, 80% (n=79) agreed to participate in the VCBT-I. The download rate of the VCBT-I was 78% (n=62/79). Several technical and contextual barriers to the delivery and the applicability of the VCBT-I emerged. However, participants reported a high level of satisfaction, and some valuable benefits at post-immediate intervention (increased knowledge about sleep, better quality of sleep, and higher acceptance of the burden of insomnia), regardless of whether or not they still had insomnia.

Discussion

This study confirms that there is a demand for a VCBT-I, which was perceived as appropriate by a sample of French cancer outpatients with insomnia, but it also highlights some limitations in terms of implementation and practicality. Remote professional support appears to be a core need in order to address these issues and personalize the guidance process.

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Data availability

Available on request

Code availability

N.A.

References

  1. Kwak A, Jacobs J, Haggett D, Jimenez R, Peppercorn J (2020) Evaluation and management of insomnia in women with breast cancer. Breast Cancer Res Treat 181(2):269–277. https://doi.org/10.1007/s10549-020-05635-0

    Article  PubMed  Google Scholar 

  2. Schieber K, Niecke A, Geiser F, Erim Y, Bergelt C, Büttner-Teleaga A, Maatouk I, Stein B, Teufel M, Wickert M, Wuensch A, Weis J (2019) The course of cancer-related insomnia: don’t expect it to disappear after cancer treatment. Sleep Med 58:107–113. https://doi.org/10.1016/j.sleep.2019.02.018

    Article  PubMed  Google Scholar 

  3. Savard J, Ivers H, Savard MH, Morin CM (2015) Cancer treatments and their side effects are associated with aggravation of insomnia: results of a longitudinal study. Cancer 121(10):1703–1711. https://doi.org/10.1002/cncr.29244

    Article  PubMed  Google Scholar 

  4. Guzman-Marin R, Avidan AY (2015) Sleep disorders in patients with cancer. J Community Support Oncol 13(4):148–155. https://doi.org/10.12788/jcso.0126

    Article  CAS  PubMed  Google Scholar 

  5. Bean HR, Diggens J, Ftanou M, Weihs KL, Stanton AL, Wiley JF (2021) Insomnia and fatigue symptom trajectories in breast cancer: a longitudinal cohort study. Behav Sleep Med 20:1–14. https://doi.org/10.1080/15402002.2020.1869005

    Article  Google Scholar 

  6. Liou KT, Ahles TA, Garland SN, Li QS, Bao T, Li Y, Root JC, Mao JJ (2019) The relationship between insomnia and cognitive impairment in breast cancer survivors. JNCI Cancer Spectr 73(3):pkz041. https://doi.org/10.1093/jncics/pkz041 eCollection 2019 Sep

    Article  Google Scholar 

  7. Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA, Lichstein KL (2006) Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004). Sleep 29:1398–1414. https://doi.org/10.1093/sleep/29.11.1398

    Article  PubMed  Google Scholar 

  8. Howell D, Oliver TK, Keller-Olaman S, Davidson J, Garland S, Samuels C et al (2013) A Pan-Canadian practice guideline: prevention, screening, assessment, and treatment of sleep disturbances in adults with cancer. Support Care Cancer 21(10):2695–2706. https://doi.org/10.1007/s00520-013-1823-6

    Article  PubMed  Google Scholar 

  9. Johnson JA, Rash JA, Campbell TS, Savard J, Gehrman PR, Perlis M, Carlson LE, Garland SN (2016) A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia (CBT-I) in cancer survivors. Sleep Med Rev 27:20–28. https://doi.org/10.1016/j.smrv.2015.07.001

    Article  PubMed  Google Scholar 

  10. Ma Y, Hall DL, Ngo LH, Liu Q, Bain PA, Yeh GY (2020) Efficacy of cognitive behavioral therapy for insomnia in breast cancer: a meta-analysis. Sleep Med Rev:101376. https://doi.org/10.1016/j.smrv.2020.101376

  11. Savard J, Villa J, Simard S, Ivers H, Morin CM (2011) Feasibility of a self-help treatment for insomnia comorbid with cancer. Psychooncology 20(9):1013–1019. https://doi.org/10.1002/pon.1818

    Article  PubMed  Google Scholar 

  12. Savard J, Ivers H, Savard MH, Morin CM (2014) Is a video-based cognitive behavioral therapy for insomnia as efficacious as a professionally administered treatment in breast cancer? Results of a randomized controlled trial. Sleep 37(8):1305–1314. https://doi.org/10.5665/sleep.3918

    Article  PubMed  PubMed Central  Google Scholar 

  13. Anderson KN, Goldsmith P, Gardiner A (2014) A pilot evaluation of an online cognitive behavioral therapy for insomnia disorder-targeted screening and interactive Web design lead to improved sleep in a community population. Nat Sci Sleep 6:43. https://doi.org/10.2147/NSS.S57852

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bowen DJ, Kreuter M, Spring B, Cofta-Woerpel L, Linnan L, Weiner D, Bakken S, Kaplan CP, Squiers L, Fabrizio C, Fernandez M (2009) How we design feasibility studies. Am J Prev Med 36(5):452–457. https://doi.org/10.1016/j.amepre.2009.02.002

    Article  PubMed  PubMed Central  Google Scholar 

  15. Morin CM (1993) Insomnia: Psychological assessment and management. Guilford Press

  16. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K (1991) The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 7(2):6–9. https://doi.org/10.1177/082585979100700202

    Article  CAS  PubMed  Google Scholar 

  17. Thomas DR (2006) A general inductive approach for analyzing qualitative evaluation data. Am J Eval 27(2):237–246. https://doi.org/10.1177/1098214005283748

    Article  Google Scholar 

  18. Matthews EE, Schmiege SJ, Cook PF, Berger AM, Aloia MS (2012) Adherence to cognitive behavioral therapy for insomnia (CBTI) among women following primary breast cancer treatment: a pilot study. Behav Sleep Med 10(3):217–229. https://doi.org/10.1080/15402002.2012.666220

    Article  PubMed  Google Scholar 

  19. Prochaska JO, DiClemente CC (1982) Transtheoretical therapy: toward a more integrative model of change. Psychotherapy 19(3):276–288. https://doi.org/10.1037/h0088437

    Article  Google Scholar 

  20. Hebert EA, Vincent N, Lewycky S, Walsh K (2010) Attrition and adherence in the online treatment of chronic insomnia. Behav Sleep Med 8(3):141–150. https://doi.org/10.1080/15402002.2010.487457

    Article  PubMed  Google Scholar 

  21. Matthews EE, Schmiege SJ, Cook PF, Berger AM, Aloia MS (2012) Adherence to cognitive behavioral therapy for insomnia (CBTI) among women following primary breast cancer treatment: a pilot study. Behav Sleep Med 10(3):217–229. https://doi.org/10.1080/15402002.2012.666220

    Article  PubMed  Google Scholar 

  22. Chan C, West S, Glozier N (2017) Commencing and persisting with a web-based cognitive behavioral intervention for insomnia: a qualitative study of treatment completers. J Med Internet Res 19(2):e37. https://doi.org/10.2196/jmir.5639

    Article  PubMed  PubMed Central  Google Scholar 

  23. Dozeman E, Verdonck-de Leeuw IM, Savard J, van Straten A (2017) Guided web-based intervention for insomnia targeting breast cancer patients: feasibility and effect. Internet Interv 9:1–6. https://doi.org/10.1016/j.invent.2017.03.005

    Article  PubMed  PubMed Central  Google Scholar 

  24. Zachariae R, Lyby MS, Ritterband LM, O'Toole MS (2016) Efficacy of internet-delivered cognitive-behavioral therapy for insomnia-a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev 30:1–10. https://doi.org/10.1016/j.smrv.2015.10.004

    Article  PubMed  Google Scholar 

  25. Yeung WF, Chung KF, Ho FYY, Ho LM (2015) Predictors of dropout from internet-based self-help cognitive behavioral therapy for insomnia. Behav Res Ther 73:19–24. https://doi.org/10.1016/j.brat.2015.07.008

    Article  PubMed  Google Scholar 

  26. Ritterband LM, Bailey ET, Thorndike FP, Lord HR, Farrell-Carnahan L, Baum LD (2012) Initial evaluation of an internet intervention to improve the sleep of cancer survivors with insomnia. Psychooncology 21(7):695–705. https://doi.org/10.1002/pon.1969

    Article  PubMed  Google Scholar 

  27. Zachariae R, Amidi A, Damholdt MF, Clausen CD, Dahlgaard J, Lord H et al (2018) Internet-delivered cognitive-behavioral therapy for insomnia in breast cancer survivors: a randomized controlled trial. J Natl Cancer Inst 110(8):880–887. https://doi.org/10.1093/jnci/djx293

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to thank the National Cancer Institute, the oncological medical teams at Gustave Roussy, and the study participants.

Funding

This research was funded by a project grant from the National Cancer Institute (INCA RISP 2016 - N° 2017-005).

Author information

Authors and Affiliations

  1. Gustave Roussy, Université Paris-Saclay, 114 Rue Edouard Vaillant, F-94805, Villejuif Cedex, France

    Diane Boinon, Cécile Charles, Léonor Fasse, Gloria Pallubicki, Sébastien Gouy, Laurence Albiges, Suzette Delaloge, David Malka, David Planchard & Sarah Dauchy

  2. Université de Paris, LPPS, F-92100, Boulogne-Billancourt, France

    Diane Boinon, Cécile Charles, Léonor Fasse, Jonathan Journiac & Kristopher Lamore

  3. Institut Régional du Cancer de Montpellier, Montpellier, France

    Grégory Ninot & Estelle Guerdoux-Ninot

  4. School of Psychology, Université Laval, Québec, Canada

    Josée Savard

  5. Centre de recherche sur le cancer, Université Laval, Québec, Canada

    Josée Savard

  6. Centre de recherche du CHU de Québec-Université Laval, Québec, Canada

    Josée Savard

Authors
  1. Diane Boinon
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Contributions

Conception and design of the study (Diane Boinon, Cécile Charles, Sarah Dauchy, Léonor Fasse, Josée Savard, Grégory Ninot, Estelle Guerdoux-Ninot); screening and recruitment of the participants of the study (Jonathan Journiac, Gloria Pallubicki); data analysis and interpretation (Diane Boinon, Cécile Charles, Sarah Dauchy); draft and revision of the paper (Diane Boinon, Cécile Charles, Sarah Dauchy, Léonor Fasse, Josée Savard, Kristopher Lamore, Sébastien Gouy, Laurence Albiges, Suzette Delaloge, David Malka, David Planchard).

Corresponding author

Correspondence to Diane Boinon.

Ethics declarations

Ethics approval

The study protocol was approved by the French regulatory and ethics authorities’ (N° ID IRB: 2018-A0026-55).

Consent to participate

All participants received oral and written information about the purpose and the procedures of the study, before signing a consent form.

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We confirm that the manuscript has been read and approved for submission by all authors that all persons listed as authors have contributed to preparing the manuscript and that no persons other than the authors listed have contributed significantly to its preparation.

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The authors declare no competing interests.

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Boinon, D., Charles, C., Fasse, L. et al. Feasibility of a video-based cognitive behavioral therapy for insomnia in French adult cancer outpatients: results from the Sleep-4-All-1 study. Support Care Cancer 29, 5883–5894 (2021). https://doi.org/10.1007/s00520-021-06151-7

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