Efficacy of an insomnia intervention on fatigue, mood and quality of life in breast cancer survivors.
OBJECTIVE
This paper is a report of a study to describe the efficacy of cognitive behavioural therapy for insomnia on fatigue, mood and quality of life in breast cancer survivors.


BACKGROUND
Women who receive primary treatment for breast cancer often complain of insomnia. Rarely evaluated in insomnia intervention studies is the effect of cognitive behavioural treatment on the psychosocial outcomes of fatigue, mood and quality of life.


METHODS
Data were collected between December 2002 and March 2004 with 72 women who were at least 3 months post-completion of primary treatment without current evidence of disease. Women were randomly assigned to either the cognitive behavioural therapy for insomnia group, which received stimulus control instructions, sleep restriction therapy and sleep education and hygiene, or the component control group which received sleep education and hygiene only. The 10-week study consisted of 2 weeks of pre-treatment, 6 weeks of treatment and 2 weeks of post-treatment. Fatigue, mood and quality of life were measured at pre- and post-treatment.


RESULTS
Women receiving cognitive behavioural therapy for insomnia had significant improvements in fatigue, trait anxiety, depression and quality of life. The component control group also had statistically significant increases in quality of life, with a trend suggestive of lower depression at post-treatment.


CONCLUSIONS
Globally, as the number of survivors in this population continues to grow, it is imperative that nurses continue testing interventions that may positively affect quality of life and the commonly experienced symptoms of fatigue, anxiety and depression.
Dirksen
Shannon R
SR
College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, Arizona, USA. shannon.dirksen@asu.edu
Epstein
Dana R
DR
D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D005221:Fatigue / Q000451:nursing / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000451:nursing / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome