QOL-05. EXPLORATORY ANALYSIS OF COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA (CBT-I) AMONG PATIENTS WITH PRIMARY BRAIN TUMOR: EFFECTS ON DEPRESSION, ANXIETY, AND LIFE QUALITY

Abstract

Abstract BACKGROUND Sleep disturbance is among the most common complaints endorsed by patients with a brain tumor diagnosis, yet the delivery of behavioral insomnia treatment is not standard practice in neuro-oncology. Our pilot trial of a 6-session group-based telehealth CBT-I program among primary brain tumor patients demonstrated clinically significant improvements in self-reported insomnia, fatigue, and sleep quality. In other cancer patient samples, CBT-I is also associated with improvements in psychosocial outcomes beyond sleep; thus, the aim of this exploratory analysis was to examine change in depression, anxiety, and life quality among primary brain tumor patients enrolled in CBT-I. METHODS This was a single-arm ORBIT Model Phase IIa proof-of-concept trial. N = 40 cognitively-intact participants (Mage = 52.4 + 12 years; 50.0% female) with a primary brain tumor and insomnia enrolled in a 6-week group-based telehealth CBT-I intervention with weekly 90-minute sessions led by graduate students in clinical psychology. Questionnaires (PHQ-9, GAD-7, EORTC-QLQ-30) were completed at baseline and 6 weeks. Within-person clinically significant improvement was calculated for intervention completers (n = 34) based on established cutoffs. RESULTS Approximately one-third of participants experienced clinically significant improvements in symptoms of depression (n = 12, 35.3%) and generalized anxiety (n = 11, 32.3%) following CBT-I, with 0 participants experiencing a clinically significant worsening of symptoms. Thirty-two of thirty-four participants (94.1%) reported clinically significant improvement in at least 1 domain of life quality spanning physical, role, emotional, and/or social functioning. CONCLUSIONS Findings suggest that a brief behavioral intervention for insomnia, CBT-I, may improve depression, anxiety, and life quality in addition to sleep among primary brain tumor patients. RESULTS from this proof-of-concept trial suggest proceeding to a test of CBT-I in comparison to a control group in order to bolster internal validity. In addition, future studies will examine sleep and related psychosocial outcomes over a longer follow-up period to assess maintenance of intervention effects.