Non-pharmacological treatment of insomnia in palliative care

Abstract

Insomnia is a common problem among patients receiving palliative care, leading to a significant deterioration in their quality of life. Both pharmacological and non-pharmacological methods are used to treat insomnia. The use of sleep medications is associated with the risk of side effects and drug interactions, so it is worth considering treatment with non-pharmacological methods, which can be as effective as pharmacotherapy but with a better safety profile. Studies have shown that non-pharmacological methods such as cognitive-behavioural therapy, physical activity, relaxation techniques, aromatherapy, and acupuncture can be beneficial in alleviating insomnia in patients under palliative care. Of particular note is cognitive-behavioural therapy, which is considered as a first-line treatment. It has also been shown that the use of palliative radiotherapy can help reduce insomnia among patients with bone metastases. There are also reports of trials of light therapy, massage therapy, and hypnotherapy, but further studies should be conducted to identify their effectiveness. An analysis of the available literature also shows that there is a paucity of high-quality studies evaluating the efficacy of the methods discussed in patients receiving palliative care. Their use is largely based on studies conducted in the general population. This article summarises the results of studies to date on non-pharmacological methods of treating insomnia in palliative medicine.