QOL-19. IMPROVING SLEEP IN THOSE WITH PRIMARY BRAIN TUMORS (PBT): A GLIMPSE INTO THE CAREGIVER’S PERSPECTIVE FOLLOWING COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA (CBT-I)

Abstract

Abstract BACKGROUND Sleep disturbance is commonly endorsed by individuals diagnosed with primary brain tumor (PBT), yet few providers in neuro-oncology assess for sleep disturbance, and even less recommend the gold standard treatment for insomnia: Cognitive Behavioral Therapy for Insomnia (CBT-I). In our pilot of a group-based, six-session, telehealth-delivered CBT-I program, PBT patients (N=44) demonstrated clinically significant improvements in self-reported insomnia, fatigue, and sleep quality. The aim of this secondary analysis was to examine informal caregivers’ perspectives of the CBT-I intervention and its impact on patients sleep. METHODS Caregivers (N=15, Mage=47.2±14; 53% female; 80% spouses; 93% cohabitating) of patients with PBT and insomnia completed a semi-structured exit interview, following their loved ones’ participation in CBT-I. Descriptive analysis included: perceived improvement in patient and caregiver sleep (rating 1-10; 1=no improvement, 10=great improvement), perceived benefits and drawbacks of CBT-I (open-ended), and caregivers’ recommendation of CBT-I to others with PBT and insomnia (Y/N). RESULTS Most caregivers (73%) noticed a moderate-to-great improvement (≥5/10) in the patient’s sleep and 20% endorsed improvements in their own sleep, following CBT-I. Observed patient benefits included: increased sleep, energy, motivation for change, use of a sleep regimen, and support. Caregivers noted minimal drawbacks of CBT-I, though some found the inflexible sleep schedule disrupted family plans and others wished to be more actively involved in the intervention. Nearly all (87%) would recommend CBT-I to others with PBT and insomnia. CONCLUSIONS Findings suggest that caregivers observed benefit in the patients’ sleep following a brief behavioral intervention for insomnia, further supporting the acceptability of CBT-I for patients with PBT and insomnia. Future directions include a randomized, two-arm pilot of CBT-I and encouraging caregiver participation in the intervention, both to increase their understanding of CBT-I intervention components for maximum benefit in the patient and to possibly improve their own sleep.