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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

Is a Video-Based Cognitive Behavioral Therapy for Insomnia as Efficacious as a Professionally... AbstractStudy Objective:To assess the short-term efficacy of a video-based cognitive behavioral therapy for insomnia (CBT-I) as compared to a professionally administered CBT-I and to a no-treatment group.Design:Randomized controlled trial.Setting:Radio-oncology department of a public hospital affiliated with Université Laval (CHU de Québec).Participants:Two hundred forty-two women with breast cancer who had received radiation therapy in the past 18 mo and who had insomnia symptoms or were using hypnotic medications were randomized to: (1) professionally administered CBT-I (PCBT-I; n = 81); (2) video-based CBT-I (VCBT-I; n = 80); and (3) no treatment (CTL; n = 81).Interventions:PCBT-I composed of six weekly, individual sessions of approximately 50 min; VCBT-I composed of a 60-min animated video + six booklets.Measurement and Results:Insomnia Severity Index (ISI) total score and sleep parameters derived from a daily sleep diary and actigraphy, collected at pretreatment and posttreatment. PCBT-I and VCBT-I were associated with significantly greater sleep improvements, assessed subjectively, as compared to CTL. However, relative to VCBT-I, PCBT-I was associated with significantly greater improvements of insomnia severity, early morning awakenings, depression, fatigue, and dysfunctional beliefs about sleep. The remission rates of insomnia (ISI < 8) were significantly greater in PCBT-I as compared to VCBT-I (71.3% versus 44.3%, P < 0.005).Conclusions:A self-administered cognitive behavioral therapy for insomnia (CBT-I) using a video format appears to be a valuable treatment option, but face-to-face sessions remain the optimal format for administering CBT-I efficaciously in patients with breast cancer. Self-help interventions for insomnia may constitute an appropriate entry level as part of a stepped care model.Trial Registration:ClinicalTrials.gov Identifier: NCT00674830. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png SLEEP Oxford University Press

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

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References (43)

Publisher
Oxford University Press
Copyright
© 2014 Associated Professional Sleep Societies, LLC.
ISSN
0161-8105
eISSN
1550-9109
DOI
10.5665/sleep.3918
pmid
25083010
Publisher site
See Article on Publisher Site

Abstract

AbstractStudy Objective:To assess the short-term efficacy of a video-based cognitive behavioral therapy for insomnia (CBT-I) as compared to a professionally administered CBT-I and to a no-treatment group.Design:Randomized controlled trial.Setting:Radio-oncology department of a public hospital affiliated with Université Laval (CHU de Québec).Participants:Two hundred forty-two women with breast cancer who had received radiation therapy in the past 18 mo and who had insomnia symptoms or were using hypnotic medications were randomized to: (1) professionally administered CBT-I (PCBT-I; n = 81); (2) video-based CBT-I (VCBT-I; n = 80); and (3) no treatment (CTL; n = 81).Interventions:PCBT-I composed of six weekly, individual sessions of approximately 50 min; VCBT-I composed of a 60-min animated video + six booklets.Measurement and Results:Insomnia Severity Index (ISI) total score and sleep parameters derived from a daily sleep diary and actigraphy, collected at pretreatment and posttreatment. PCBT-I and VCBT-I were associated with significantly greater sleep improvements, assessed subjectively, as compared to CTL. However, relative to VCBT-I, PCBT-I was associated with significantly greater improvements of insomnia severity, early morning awakenings, depression, fatigue, and dysfunctional beliefs about sleep. The remission rates of insomnia (ISI < 8) were significantly greater in PCBT-I as compared to VCBT-I (71.3% versus 44.3%, P < 0.005).Conclusions:A self-administered cognitive behavioral therapy for insomnia (CBT-I) using a video format appears to be a valuable treatment option, but face-to-face sessions remain the optimal format for administering CBT-I efficaciously in patients with breast cancer. Self-help interventions for insomnia may constitute an appropriate entry level as part of a stepped care model.Trial Registration:ClinicalTrials.gov Identifier: NCT00674830.

Journal

SLEEPOxford University Press

Published: Aug 1, 2014

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