The effect of online cognitive behavioral therapy for insomnia in adolescents and young adults after childhood cancer: Results from a randomized controlled trial
Mené sur 54 adolescents ou jeunes adutes ayant survécu à un cancer et souffrant d'insomnie sévère (âge moyen : 18,5 ans ; 68,9 % de filles), cet essai randomisé évalue l'effet, sur l'insomnie, la fatigue et la qualité de vie liée à la santé, d'une thérapie cognitivo-comportementale par internet
Background: Insomnia is common during and after childhood cancer and associated with negative health outcomes and impaired quality of life. Many adolescents and young adults do not receive treatment. Internet-delivered cognitive behavioral therapy for insomnia (iCBT-i) can fill this gap. This study assesses the effectiveness of the iCBT-i intervention “iSleep youth”.
Methods: Patients (12–30 years old) with an Insomnia Severity Index ≥8, ≥6 months after treatment, and <10 years after diagnosis were 1:1 randomized to iSleep youth or the wait list-control group. iSleep youth consists of five online sessions with a coach. Outcomes were sleep efficiency (actigraph-based), insomnia, fatigue, and health-related quality of life (HRQOL). Differences over time between iSleep youth and controls, 3 months (T3) and 6 months (T6) from baseline, were assessed with linear mixed models, controlling for age, sex, and time since end of treatment. iSleep youth also had a follow-up measurement after 12 months (T12).
Results: Fifty-four (response rate, 49%) patients participated: 68.9% females, mean age, 18.5 years (SD = 3.5), and mean time since end of treatment 3.8 years (SD = 2.3). No significant effects between the two groups were found for sleep efficiency. However, iSleep youth had a beneficial effect on insomnia severity at T3 (β = –0.79) and T6 (β = –0.55), on fatigue at T3 (β = –1.08) and T6 (β = –0.52) and on HRQOL at T3 (β = 0.46) and T6 (β = 0.62). The scores did not change from T6 to T12 in iSleep youth.
Conclusions: iSleep youth is effective in treating insomnia and concurrent fatigue in adolescents and young adults after childhood cancer and should be implemented.
Cancer 2024