Exploring the feasibility of using cognitive behavioural therapy for insomnia to improve perceived cognitive impairment in survivors of breast cancer

Walsh, Nyissa (2020) Exploring the feasibility of using cognitive behavioural therapy for insomnia to improve perceived cognitive impairment in survivors of breast cancer. Masters thesis, Memorial University of Newfoundland.

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Abstract

Objectives: The prevalence of both insomnia and cognitive impairment in survivors of breast cancer is well documented. Although there are currently effective treatments for insomnia, very few, if any, treatments are effective for improving cognitive impairment. This study evaluated the feasibility and acceptability of using Cognitive Behavioural Therapy for Insomnia (CBT-I), a gold-standard insomnia intervention, for the secondary benefit of improving perceived cognitive impairment (PCI) in survivors of breast cancer. Methods: We recruited 10 female survivors of breast cancer who resided in St. John’s, Newfoundland. Participants underwent 7 weekly sessions of CBT-I treatment and completed questionnaires to assess cognitive functioning, sleep, and psychological wellbeing at baseline, 2 months (post-treatment), and 3- and 6-months following treatment, for a total study time of 8 months. Repeated measures ANOVAs with pairwise comparisons were conducted to determine changes in symptomology. Results: Out of 45 participants screened, 10 were both eligible and enrolled, for a recruitment feasibility rate of 22%. The intervention was highly acceptable with 100% of enrolled participants completing treatment. There were statistically significant improvements in PCI [p < .001, Ƞp² = .546], insomnia [p < .001, Ƞp² = .739], fatigue [p = .004, Ƞp² = .379] and depression [p = .03, Ƞp² = .276], over the 8-month study period. Pairwise comparisons revealed significant decreases in PCI from baseline to post treatment [p = .006], 3 months [p = .003] and 6 months [p = .002]. Conclusions: CBT-I seems to be an acceptable and potentially efficacious option for improving PCI in survivors of breast cancer, but future adequately powered randomized controlled trials are needed to confirm these preliminary results. In order for such trials to recruit the required sample size, they will likely need to screen 5 times the number of participants needed.

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