A randomized controlled trial of cognitive behaviour therapy for insomnia and perceived cognitive impairment in cancer survivors
For cancer survivors, one of the biggest barriers to getting back to "normal" is perceived cognitive impairment (PCI). Approximately 75% of cancer patients have difficulty remembering things, concentrating, and paying attention after completing cancer treatments. No one agrees on the best way of treating PCI. Insomnia is also an extremely common side effect of cancer and can increase cognitive impairments.
Cognitive Behaviour Therapy for Insomnia (CBT-I) is the recommended treatment for insomnia in cancer survivors. Our research suggests that CBT-I may also improve PCI but we need to investigate this question with better measures of cognitive abilities and sleep.
We will recruit 135 people with insomnia and cognitive complaints who have completed cancer treatment at least 12 months prior to the study. Participants will be randomly assigned to receive immediate treatment with CBT-I or treatment after an 8-week waiting period.
We want to determine whether treating insomnia with CBT-I can also improve PCI. For this, we will measure changes in cognitive abilities and sleep in a few ways. Patients will report on their own perception of their cognitive abilities. We will also ask participants to remember lists of words and follow instructions. Sleep will be assessed using sleep diaries and actigraphy, a type of "wristwatch" that can detect sleep based on whether or not a person is moving. We will also measure fatigue, anxiety, and depression, as we know these can also impact sleep and cognition. This study will take place in Newfoundland which has the highest incidence rate for cancer in Canada. The relative survival rate for cancer is better than ever before, meaning that more people will be living as cancer survivors and managing the long term side effects of the disease and its treatment. This research will expand currently available treatment options in order to address two of the most problematic consequences of cancer.