0824 The Effect of CBT-I Dose on Sleep Outcomes in Cancer Survivors at 3-month Follow-up

Abstract

Abstract Introduction Cancer-related fatigue (CRF) is highly prevalent during acute illness and survivorship, with almost 100% of cancer patients experiencing such symptomatology. While CRF commonly co-occurs with sleep disturbance during and/or after cancer treatment, CRF is (nevertheless) defined as occurring independent of sleep considerations. Last year it was reported (based on preliminary findings from a pilot study), that CBT-I affects both sleep continuity and fatigue, with high dose CBT-I producing up to a 72% reduction in pre-to-post measures of Fatigue. The present analysis is based on a completed pilot study where we evaluate the durability of the anti-fatigue and sleep continuity effects of CBT-I in patients diagnosed with breast and prostate cancer. Methods This descriptive analysis (percent change from post-treatment to three month follow-up) includes 11 adult subjects (91% female; Mage=57.8±7.7yrs). CBT-I was provided by a master CBT-I therapist via video conferencing (telehealth CBT-I). Subjects were asked to complete sleep diaries, and weekly measures of fatigue (FACIT), and insomnia severity (ISI) questionnaires. In order to evaluate durability, post-treatment scores were compared to three-month follow-up scores, where all subjects were typed for whether or not they retained > 90% of their clinical gains as assessed with the ISI and the FACIT. Results 82% of the subjects in our pilot study maintained their clinical gains with respect to fatigue and 64% maintained their gains with respect to insomnia. Conclusion This preliminary analyses suggest that clinical gains via CBT-I are remarkably robust for fatigue outcomes. The findings with respect to the ISI, while less robust, are within the range that is typical for insomnia RCTs (~70% of subjects maintain treatment responses at follow-ups). If these results are replicated, this may suggest that the anti-fatigue effects of CBT-I are more durable than the “insomnialytic” effects. Support (if any) 5T32HL00795320;K24AG055602