Skip to main content
Top
Published in: Supportive Care in Cancer 3/2004

01-03-2004 | Original Article

Sleep management training for cancer patients with insomnia

Authors: Rainer Simeit, Ruth Deck, Beate Conta-Marx

Published in: Supportive Care in Cancer | Issue 3/2004

Login to get access

Abstract

Insomnia is a common phenomenon in cancer patients; nevertheless, there are only a few intervention results published covering this topic. We examined the effects of a multi-modal psychological sleep management programme combining relaxation techniques, sleep hygiene, cognitive techniques and advice in stimulus control technique on various sleep and quality-of-life variables. We compared two intervention groups up to 6 months after treatment, one with progressive muscle relaxation (n=80), the other with autogenic training (n=71). A control group (n=78) received only a standard rehabilitation programme. It was a heterogeneous sample of adult patients (mean age 58 years) predominantly with breast, kidney or prostate cancer staying for 3 or 4 weeks in an oncological rehabilitation clinic. In comparison to the control group, the analysis of variance for repeated measures (R-MANOVA) showed significant improvements over time, indicating that intervention group participants benefited with moderate- or large-scale effects on sleep latency (p<0.001), sleep duration (p<0.001), sleep efficiency (p<0.001), sleep quality (p<0.001), sleep medication (p<0.05) and daytime dysfunction (p<0.05). In quality-of-life subscales, there was mainly improvement over time. This may indicate a benefit of the rehabilitation treatment in general. No evidence was found for any differences between the two intervention groups. The results suggest that the use of a multi-modal psychological sleep intervention could enhance various sleep parameters and well being of patients. The efficacy on quality of life is still under review.
Literature
1.
go back to reference Aaronson NK, Ahmedzai S, Bergman B (1993) The EORTC QLQ-C30: A quality of life instrument for use in international clinical trials in oncology. J Nat Canc Inst 85:365–376CrossRef Aaronson NK, Ahmedzai S, Bergman B (1993) The EORTC QLQ-C30: A quality of life instrument for use in international clinical trials in oncology. J Nat Canc Inst 85:365–376CrossRef
2.
go back to reference American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington DC American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington DC
3.
go back to reference Ancoli-Israel S, Moore PJ, Jones V (2001) The relationship between fatigue and sleep in cancer patients: a review. Europ J Canc Care 10:245–255CrossRef Ancoli-Israel S, Moore PJ, Jones V (2001) The relationship between fatigue and sleep in cancer patients: a review. Europ J Canc Care 10:245–255CrossRef
4.
go back to reference Backhaus J, Riemann D (1999) Schlafstörungen. Hogrefe, Göttingen Bern Toronto Seattle Backhaus J, Riemann D (1999) Schlafstörungen. Hogrefe, Göttingen Bern Toronto Seattle
5.
go back to reference Behre A, Scholz OB (1998) Behandlungswirkungen standardisierter hypnotherapeutischer Suggestionen bei Patienten mit Schlafstörungen. Hypnose und Kognition 15:113–127 Behre A, Scholz OB (1998) Behandlungswirkungen standardisierter hypnotherapeutischer Suggestionen bei Patienten mit Schlafstörungen. Hypnose und Kognition 15:113–127
6.
go back to reference Bernstein DA, Borkovec TD (1973) Progressive Relaxation Training. Research Press, Champaign Bernstein DA, Borkovec TD (1973) Progressive Relaxation Training. Research Press, Champaign
7.
go back to reference Bootzin RR, Epstein D, Wood JM (1991) Stimulus control instructions. In: Hauri P (ed) Case studies in insomnia. Plenum, New York, pp 19–28 Bootzin RR, Epstein D, Wood JM (1991) Stimulus control instructions. In: Hauri P (ed) Case studies in insomnia. Plenum, New York, pp 19–28
8.
go back to reference Borkovec TD, Fowles DC (1973) Controlled investigation of the effects of progressive and hypnotic relaxation on insomnia. J of Abnorm Psychol Borkovec TD, Fowles DC (1973) Controlled investigation of the effects of progressive and hypnotic relaxation on insomnia. J of Abnorm Psychol
9.
go back to reference Bottomley A, Vanvoorden V, Flechtner H, Therasse P (2003) The challenges and achievements involved in implementing quality of life research in cancer clinical trials. Eur J Cancer 39:275–285CrossRefPubMed Bottomley A, Vanvoorden V, Flechtner H, Therasse P (2003) The challenges and achievements involved in implementing quality of life research in cancer clinical trials. Eur J Cancer 39:275–285CrossRefPubMed
10.
go back to reference Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR (2000) Fatigue in breast cancer survivors: Occurrence, correlates, and impact on quality of life. J Clin Oncol 18:743–753PubMed Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR (2000) Fatigue in breast cancer survivors: Occurrence, correlates, and impact on quality of life. J Clin Oncol 18:743–753PubMed
11.
go back to reference Cannici J, Malcolm R, Peek LA (1983) Treatment of insomnia in cancer patients using muscle relaxation training. J Behav Ther Exp Psychiatry 14:251–256CrossRefPubMed Cannici J, Malcolm R, Peek LA (1983) Treatment of insomnia in cancer patients using muscle relaxation training. J Behav Ther Exp Psychiatry 14:251–256CrossRefPubMed
12.
go back to reference Carpenter JS, Andrykowski MA (1998) Psychometric evaluation of the Pittsburgh Sleep Quality Index. J Psychosom Res 45:5–13CrossRefPubMed Carpenter JS, Andrykowski MA (1998) Psychometric evaluation of the Pittsburgh Sleep Quality Index. J Psychosom Res 45:5–13CrossRefPubMed
13.
go back to reference Cimprich B (1999) Pretreatment symptom distress in women newly diagnosed with breast cancer. Cancer Nurs 22:185–194CrossRefPubMed Cimprich B (1999) Pretreatment symptom distress in women newly diagnosed with breast cancer. Cancer Nurs 22:185–194CrossRefPubMed
14.
go back to reference Couzi RJ, Helzlsouer KJ, Fetting JH (1995) Prevalence of menopausal symptoms among women with a history of breast cancer and attitudes toward estrogen replacement therapy. J Clin Oncol 13:2737–2744PubMed Couzi RJ, Helzlsouer KJ, Fetting JH (1995) Prevalence of menopausal symptoms among women with a history of breast cancer and attitudes toward estrogen replacement therapy. J Clin Oncol 13:2737–2744PubMed
15.
go back to reference Davidson JR, MacLean AW, Brundage MD, Schulze K (2002) Sleep disturbance in cancer patients. Soc Sc Med 54:1309–1321CrossRef Davidson JR, MacLean AW, Brundage MD, Schulze K (2002) Sleep disturbance in cancer patients. Soc Sc Med 54:1309–1321CrossRef
16.
go back to reference de Jong N, Courtens AM, Abu-Saad, HH, Schouten, HC (2002) Fatigue in patients with breast cancer receiving adjuvant chemotherapy: A review of the literature. Canc Nurs 25:283–299 de Jong N, Courtens AM, Abu-Saad, HH, Schouten, HC (2002) Fatigue in patients with breast cancer receiving adjuvant chemotherapy: A review of the literature. Canc Nurs 25:283–299
17.
go back to reference Derogatis, LR, Feldstein M, Morrow G, et al (1979) A survey of psychotropic drug prescriptions in an oncology population. Cancer 44:1919–1929PubMed Derogatis, LR, Feldstein M, Morrow G, et al (1979) A survey of psychotropic drug prescriptions in an oncology population. Cancer 44:1919–1929PubMed
18.
go back to reference Dinges DF, Douglas SD, Zangg L, Campbell DE et al (1994) Leukocytosis and natural killer cell function parallel neurobehavioral fatigue induced by 64 hours of sleep deprivation. J Clin Invest 93:1930–1939PubMed Dinges DF, Douglas SD, Zangg L, Campbell DE et al (1994) Leukocytosis and natural killer cell function parallel neurobehavioral fatigue induced by 64 hours of sleep deprivation. J Clin Invest 93:1930–1939PubMed
19.
go back to reference Dolan JD (1984) The self-management of sleep interruptions, pain and nausea by adult oncology outpatients: An investigation. Diss Abstr Int B 45:826 Dolan JD (1984) The self-management of sleep interruptions, pain and nausea by adult oncology outpatients: An investigation. Diss Abstr Int B 45:826
20.
go back to reference Edinger JD, Wohlgemuth WK (1999) The significance and management of persistent primary insomnia: The past, present and future of behavioral insomnia therapies. Sleep Med Rev 3:101–118 Edinger JD, Wohlgemuth WK (1999) The significance and management of persistent primary insomnia: The past, present and future of behavioral insomnia therapies. Sleep Med Rev 3:101–118
21.
go back to reference Efficace F, Bottomley A, van Andel G (2003) Health related quality of life in prostate carcinoma patients: a systematic review of randomized controlled trials. Cancer 97:377–388CrossRefPubMed Efficace F, Bottomley A, van Andel G (2003) Health related quality of life in prostate carcinoma patients: a systematic review of randomized controlled trials. Cancer 97:377–388CrossRefPubMed
22.
go back to reference Engstrom C, Strohl R, Rose L et al (1999) Sleep alterations in cancer patients. Canc Nurs 22:143–148CrossRef Engstrom C, Strohl R, Rose L et al (1999) Sleep alterations in cancer patients. Canc Nurs 22:143–148CrossRef
23.
go back to reference Ford D, Kamerow D (1989) Epidemiologic study of sleep disturbances and psychiatric disorders: An opportunity for prevention? JAMA, 262:1479–1484 Ford D, Kamerow D (1989) Epidemiologic study of sleep disturbances and psychiatric disorders: An opportunity for prevention? JAMA, 262:1479–1484
24.
go back to reference Fortner, B. Stepanski E, Wang S. et al (2002) Sleep and quality of life in breast cancer patients. J Pain Symptom Manage, 24:471–480 Fortner, B. Stepanski E, Wang S. et al (2002) Sleep and quality of life in breast cancer patients. J Pain Symptom Manage, 24:471–480
25.
go back to reference Holzrichter S, Hajak G, Rudolph, G, Westenhöfer F, et al (1994) Wie schlafen die Deutschen–eine Repräsentativumfrage in Westdeutschland. Medizin Wochenschr (Sonderheft) 62–73 Holzrichter S, Hajak G, Rudolph, G, Westenhöfer F, et al (1994) Wie schlafen die Deutschen–eine Repräsentativumfrage in Westdeutschland. Medizin Wochenschr (Sonderheft) 62–73
26.
go back to reference Hu D, Silberfarb PM (1991) Management of sleep problems in cancer patients. Oncology 5:23–28 Hu D, Silberfarb PM (1991) Management of sleep problems in cancer patients. Oncology 5:23–28
27.
go back to reference Irwin M, Smith T, Gillin C (1992) Electroencephalographic sleep and natural killer cell activity in depressed patients and control subjects. Psychosom Med 54:10–21PubMed Irwin M, Smith T, Gillin C (1992) Electroencephalographic sleep and natural killer cell activity in depressed patients and control subjects. Psychosom Med 54:10–21PubMed
28.
go back to reference Irwin M, Fortner M, Clark C, McClintick J, Costlow C et al (1995) Reduction of natural killer cell activity in primary insomnia and in major depression. Sleep Res 24:256 Irwin M, Fortner M, Clark C, McClintick J, Costlow C et al (1995) Reduction of natural killer cell activity in primary insomnia and in major depression. Sleep Res 24:256
29.
go back to reference Jereczek-Fossa BA, Marsiglia HR, Orecchia R (2002) Radiotherapy-related fatigue. Cirt Rev Oncol Hematol 41:317–325 Jereczek-Fossa BA, Marsiglia HR, Orecchia R (2002) Radiotherapy-related fatigue. Cirt Rev Oncol Hematol 41:317–325
30.
go back to reference Kales, JD, Kales A, Bixler EO et al (1984) Biopsychobehavioral correlates of insomnia. V: Clinical characteristics and behavioral correlates. Am J Psychiatry 141:1371–1376PubMed Kales, JD, Kales A, Bixler EO et al (1984) Biopsychobehavioral correlates of insomnia. V: Clinical characteristics and behavioral correlates. Am J Psychiatry 141:1371–1376PubMed
31.
go back to reference Kaye J, Kaye K, Madow L (1983) Sleep patterns in patients with cancer and patients with cardiac disease. J Psychol 114:107–113PubMed Kaye J, Kaye K, Madow L (1983) Sleep patterns in patients with cancer and patients with cardiac disease. J Psychol 114:107–113PubMed
32.
go back to reference Lacks P, Morin CM (1992) Recent advances in the assessment and treatment of insomnia. J Consult Clin Psychol 60:586–594CrossRefPubMed Lacks P, Morin CM (1992) Recent advances in the assessment and treatment of insomnia. J Consult Clin Psychol 60:586–594CrossRefPubMed
33.
go back to reference Lichstein KL, Means MK, Noe SL, et al (1997) Fatigue and sleep disorders. Behav Res Ther 35;733–740 Lichstein KL, Means MK, Noe SL, et al (1997) Fatigue and sleep disorders. Behav Res Ther 35;733–740
34.
go back to reference Linden W, (1990) Autogenic Training: a Clinical Guide. Guilford, New York Linden W, (1990) Autogenic Training: a Clinical Guide. Guilford, New York
35.
go back to reference Lindley, C, Vasa S, Sawyer WT, Winer EP (1998) Quality of life and preferences for treatment following systemic adjuvant therapy for early-stage breast cancer J Clin Oncol 16:1380–1387 Lindley, C, Vasa S, Sawyer WT, Winer EP (1998) Quality of life and preferences for treatment following systemic adjuvant therapy for early-stage breast cancer J Clin Oncol 16:1380–1387
36.
go back to reference Malone M, Harris AL, Luscombe DK (1994) Assessment of the impact of cancer on work, recreation, home, management and sleep using a general health status measure. J R Soc Med 87:386–389PubMed Malone M, Harris AL, Luscombe DK (1994) Assessment of the impact of cancer on work, recreation, home, management and sleep using a general health status measure. J R Soc Med 87:386–389PubMed
37.
go back to reference Mellinger GD, Balter MB, Uhlenhuth EH (1985) Insomnia and its treatment Prevalence and correlates. Arch Gen Psychiatry 42:225–232PubMed Mellinger GD, Balter MB, Uhlenhuth EH (1985) Insomnia and its treatment Prevalence and correlates. Arch Gen Psychiatry 42:225–232PubMed
38.
go back to reference Molassiotis A, Yung HP, Yam BM, Chan FY, Mok TS (2002) The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: a randomised controlled trial. Supp Care Cancer 10:237–246CrossRef Molassiotis A, Yung HP, Yam BM, Chan FY, Mok TS (2002) The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: a randomised controlled trial. Supp Care Cancer 10:237–246CrossRef
39.
go back to reference Morrow GR, Andrews PL, Hickok JT, Roscoe JA, Mattesou S (2002) Fatigue in patients with breast cancer receiving adjuvant chemotherapy: A review of the literature. Supp Care Cancer 10:389–398CrossRef Morrow GR, Andrews PL, Hickok JT, Roscoe JA, Mattesou S (2002) Fatigue in patients with breast cancer receiving adjuvant chemotherapy: A review of the literature. Supp Care Cancer 10:389–398CrossRef
40.
go back to reference Müller T, Paterok B (1999) Schlaftraining. Hogrefe. Göttingen Müller T, Paterok B (1999) Schlaftraining. Hogrefe. Göttingen
41.
go back to reference Nicholi AM (1978) The Harvard guide to modern psychiatry. Belknap, Cambridge, MA Nicholi AM (1978) The Harvard guide to modern psychiatry. Belknap, Cambridge, MA
42.
go back to reference Passik SD, Whitcomb LA, Kirsh KL, Theobald DE (2003) An unsuccessful attempt to develop a single-item screen for insomnia in cancer patients. J Pain Symptom Manage 25:284–287CrossRefPubMed Passik SD, Whitcomb LA, Kirsh KL, Theobald DE (2003) An unsuccessful attempt to develop a single-item screen for insomnia in cancer patients. J Pain Symptom Manage 25:284–287CrossRefPubMed
43.
go back to reference Penson DF, Litwin MS, Aaronson NK (2003) Health related quality of life in men with prostate cancer. J Urol 169:1653–1661PubMed Penson DF, Litwin MS, Aaronson NK (2003) Health related quality of life in men with prostate cancer. J Urol 169:1653–1661PubMed
44.
go back to reference Quesnel C, Savard J, Simard S, Ivers H, Morin CM (2003) Efficacy of cognitive-behavioral therapy for insomnia in women treated for nonmetastatic breast cancer. J Consult Clin Psychol 71:189–200CrossRefPubMed Quesnel C, Savard J, Simard S, Ivers H, Morin CM (2003) Efficacy of cognitive-behavioral therapy for insomnia in women treated for nonmetastatic breast cancer. J Consult Clin Psychol 71:189–200CrossRefPubMed
45.
go back to reference Savard J, Morin CM (2001) Insomnia in the context of cancer: A review of a neglected problem. J Clin Oncol 19:895–908PubMed Savard J, Morin CM (2001) Insomnia in the context of cancer: A review of a neglected problem. J Clin Oncol 19:895–908PubMed
46.
go back to reference Savard J, Simard S, Quesnel C et al (2000) Preliminary results of a randomized trial on the efficacy of cognitive-behavioral treatment for insomnia in breast cancer. Int J Behav Med 7:35 Savard J, Simard S, Quesnel C et al (2000) Preliminary results of a randomized trial on the efficacy of cognitive-behavioral treatment for insomnia in breast cancer. Int J Behav Med 7:35
47.
go back to reference Savard J, Simard S, Blanchet J, Ivers H, Morin CM (2001) Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep 24:583–590PubMed Savard J, Simard S, Blanchet J, Ivers H, Morin CM (2001) Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep 24:583–590PubMed
48.
go back to reference Silberfarb PM, Hauri PJ, Oxman TE, Lash S (1985) Insomnia in cancer patients. Soc Sc Med 20:849–850CrossRef Silberfarb PM, Hauri PJ, Oxman TE, Lash S (1985) Insomnia in cancer patients. Soc Sc Med 20:849–850CrossRef
49.
go back to reference Smets EM, Garssen B, Schuster-Uitterhoeve AL, de Haes JC (1993) Fatigue in cancer patients. Br J Cancer 68:220–224PubMed Smets EM, Garssen B, Schuster-Uitterhoeve AL, de Haes JC (1993) Fatigue in cancer patients. Br J Cancer 68:220–224PubMed
50.
go back to reference Stam HJ, Bultz BD (1986) The treatment of severe insomnia in a cancer patient. J Behav Ther Exp Psychiatry 17:33–37CrossRefPubMed Stam HJ, Bultz BD (1986) The treatment of severe insomnia in a cancer patient. J Behav Ther Exp Psychiatry 17:33–37CrossRefPubMed
51.
go back to reference Weyerer S, Dilling H (1991) Prevalence and treatment of insomnia in the community: Results from the Upper Bavarian filed study. Sleep 14:392–398PubMed Weyerer S, Dilling H (1991) Prevalence and treatment of insomnia in the community: Results from the Upper Bavarian filed study. Sleep 14:392–398PubMed
52.
go back to reference Wright S, Courtney U, Crowther D (2002) A quantitative and qualitative pilot study of the perceived benefits of autogenic training for a group of people with cancer. Europ J Canc Care 11:122–130CrossRef Wright S, Courtney U, Crowther D (2002) A quantitative and qualitative pilot study of the perceived benefits of autogenic training for a group of people with cancer. Europ J Canc Care 11:122–130CrossRef
Metadata
Title
Sleep management training for cancer patients with insomnia
Authors
Rainer Simeit
Ruth Deck
Beate Conta-Marx
Publication date
01-03-2004
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 3/2004
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-004-0594-5

Other articles of this Issue 3/2004

Supportive Care in Cancer 3/2004 Go to the issue

Forthcoming Meetings

March 2004

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine