title: 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.
abstract: 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.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Radio-oncology department of a public hospital affiliated with Université Laval (CHU de Québec).
  
  
  METHODS
  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).
  
  
  METHODS
  PCBT-I composed of six weekly, individual sessions of approximately 50 min; VCBT-I composed of a 60-min animated video + six booklets.
  
  
  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.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT00674830.
  
  
  BACKGROUND
  Savard J, Ivers H, Savard MH, Morin CM. 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.
authors.affiliation: School of Psychology, Université Laval, Québec, Canada ; Centre de recherche sur le cancer, Université Laval, Québec, Canada ; Centre de recherche du CHU de Québec, Québec, Canada.
authors.forename: Josée
authors.initials: J
authors.lastname: Savard
authors.affiliation: School of Psychology, Université Laval, Québec, Canada ; Centre de recherche sur le cancer, Université Laval, Québec, Canada ; Centre de recherche du CHU de Québec, Québec, Canada.
authors.forename: Hans
authors.initials: H
authors.lastname: Ivers
authors.affiliation: Centre de recherche sur le cancer, Université Laval, Québec, Canada ; Centre de recherche du CHU de Québec, Québec, Canada.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Savard
authors.affiliation: School of Psychology, Université Laval, Québec, Canada.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Morin
mesh_terms: D056044:Actigraphy; D001943:Breast Neoplasms / Q000150:complications*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000150:complications; D005221:Fatigue / Q000150:complications; D005260:Female; D006801:Humans; D008875:Middle Aged; D011792:Quebec; D012890:Sleep / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D013997:Time Factors; D014741:Video Recording
keywords: RCT; cancer; cognitive behavioral therapy; insomnia; low intensity treatment; self-help treatment; stepped care; video
references.citation: Behav Res Methods. 2009 Nov;41(4):1149-60
references.pmid: 19897823
references.citation: Psychooncology. 2009 Jun;18(6):634-46
references.pmid: 19090531
references.citation: Am J Psychiatry. 2002 Jan;159(1):5-11
references.pmid: 11772681
references.citation: Cancer Nurs. 2003 Apr;26(2):143-54
references.pmid: 12660563
references.citation: J Clin Oncol. 2009 Dec 10;27(35):6033-40
references.pmid: 19884558
references.citation: Sleep. 2005 Sep;28(9):1049-57
references.pmid: 16268373
references.citation: J Clin Oncol. 2009 Nov 1;27(31):5233-9
references.pmid: 19738124
references.citation: Sleep. 2005 Oct;28(10):1319-27
references.pmid: 16295218
references.citation: Am J Psychiatry. 1994 Aug;151(8):1172-80
references.pmid: 8037252
references.citation: Psychooncology. 2005 Jun;14(6):429-41
references.pmid: 15376284
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Support Care Cancer. 2004 Mar;12(3):176-83
references.pmid: 14760542
references.citation: J Clin Oncol. 2010 Jan 10;28(2):292-8
references.pmid: 19933917
references.citation: Sleep. 2009 Apr;32(4):499-510
references.pmid: 19413144
references.citation: J Consult Clin Psychol. 2000 Aug;68(4):549-55
references.pmid: 10965629
references.citation: Behav Sleep Med. 2013;11(5):328-42
references.pmid: 23286463
references.citation: Sleep. 2009 Dec;32(12):1549-58
references.pmid: 20041590
references.citation: Sleep Med Rev. 2009 Feb;13(1):61-71
references.pmid: 18952469
references.citation: Psychooncology. 2012 Jul;21(7):695-705
references.pmid: 21538678
references.citation: J Clin Oncol. 2008 Oct 1;26(28):4651-8
references.pmid: 18591549
references.citation: Oncol Nurs Forum. 2007 Sep;34(5):E51-9
references.pmid: 17878117
references.citation: J Natl Cancer Inst. 1993 Mar 3;85(5):365-76
references.pmid: 8433390
references.citation: Psychooncology. 2001 Sep-Oct;10(5):389-97
references.pmid: 11536417
references.citation: Psychooncology. 2011 Sep;20(9):1013-9
references.pmid: 20677329
references.citation: Sleep. 2007 Nov;30(11):1547-54
references.pmid: 18041487
references.citation: J Pers Assess. 1998 Dec;71(3):349-67
references.pmid: 9933941
references.citation: J Consult Clin Psychol. 1999 Aug;67(4):511-9
references.pmid: 10450621
references.citation: Acta Psychiatr Scand. 1983 Jun;67(6):361-70
references.pmid: 6880820
references.citation: J Psychosom Res. 1995 Apr;39(3):315-25
references.pmid: 7636775
references.citation: Br J Psychiatry. 2005 Jan;186:11-7
references.pmid: 15630118
references.citation: Psychol Aging. 1995 Mar;10(1):54-63
references.pmid: 7779317
references.citation: Sleep Med. 2001 Jul;2(4):297-307
references.pmid: 11438246
references.citation: Psychol Aging. 2002 Jun;17(2):288-98
references.pmid: 12061413
references.citation: J Clin Oncol. 2005 Sep 1;23(25):6083-96
references.pmid: 16135475
references.citation: J Consult Clin Psychol. 2004 Aug;72(4):653-9
references.pmid: 15301650
references.citation: J Consult Clin Psychol. 1995 Feb;63(1):79-89
references.pmid: 7896994
references.citation: J Clin Oncol. 2011 Sep 10;29(26):3580-6
references.pmid: 21825267
references.citation: Addiction. 2004 Sep;99(9):1121-32
references.pmid: 15317632
references.citation: J Consult Clin Psychol. 2003 Feb;71(1):189-200
references.pmid: 12602439
references.citation: Support Care Cancer. 2012 Jun;20(6):1203-10
references.pmid: 21637975