title: Adherence to cognitive behavioral therapy for insomnia (CBTI) among women following primary breast cancer treatment: a pilot study.
abstract: Cognitive behavioral therapy for insomnia (CBTI) has proven efficacy, yet 32%-89% of patients fail to consistently follow recommendations. This pilot study examines adherence to CBTI in breast cancer survivors with insomnia. There was a significant decline in adherence to prescribed rise time, and total time in bed, but no change in adherence to prescribed bedtime during six weekly sessions. Factors associated with higher adherence included lower fatigue and higher baseline motivation. Higher adherence was associated with worse subjective sleep quality at the beginning of CBTI and fewer nocturnal awakenings at the end of treatment. Results provide preliminary evidence supporting the impact of adherence on sleep outcomes such as fewer nocturnal awakenings. Attention to adherence as part of CBTI may yield greater sleep improvements.
authors: University of Colorado, College of Nursing, 13120 East 19th Ave, Aurora, CO 80045, USA. ellyn.matthews@ucdenver.edu
authors: Ellyn E
authors: EE
authors: Matthews
authors: Sarah J
authors: SJ
authors: Schmiege
authors: Paul F
authors: PF
authors: Cook
authors: Ann M
authors: AM
authors: Berger
authors: Mark S
authors: MS
authors: Aloia
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010865:Pilot Projects; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D017741:Survivors / Q000523:psychology*; D014930:Women / Q000523:psychology*