Adherence to Cognitive Behavioral Therapy for Insomnia (CBTI) Among Women Following Primary Breast Cancer Treatment: A Pilot Study

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 t...

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Bibliographic Details
Published in:Behavioral sleep medicine 2012-01, Vol.10 (3), p.217-229
Main Authors: Matthews, Ellyn E., Schmiege, Sarah J., Cook, Paul F., Berger, Ann M., Aloia, Mark S.
Format: Article
Language:English
Subjects:
Adherence
Adult
Aged
Awakening
Behavior modification
Breast cancer
Breast Neoplasms - complications
Breast Neoplasms - drug therapy
Breast Neoplasms - psychology
Breast Neoplasms - therapy
Cognitive behaviour therapy
Cognitive therapy
Cognitive Therapy - methods
Cognitive Therapy - statistics & numerical data
Female
Humans
Insomnia
Medical Records - statistics & numerical data
Middle Aged
Motivation
Patient Compliance - psychology
Patient Compliance - statistics & numerical data
Pilot Projects
Pilot studies
Prescribed
Severity of Illness Index
Sleep
Sleep Initiation and Maintenance Disorders - complications
Sleep Initiation and Maintenance Disorders - psychology
Sleep Initiation and Maintenance Disorders - therapy
Studies
Survivors - psychology
Women
Women - psychology
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Summary: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.
ISSN:1540-2002
1540-2010
DOI:10.1080/15402002.2012.666220