0360 Goldilocks's Insomnia: Finding the ‘Just Right’ Treatment for Cancer Survivors in a Stepped Care Program

Abstract

Introduction: Cancer treatments are associated with many long-term health consequences. Insomnia is one of the most common. Though behavioral treatments for insomnia are effective, access is limited, especially at cancer centers. There is increasing interest in the implementation of stepped care models in the treatment of insomnia to potentially improve patient accessibility. We evaluated the efficacy of stepped insomnia treatment at a comprehensive cancer center. Method(s): 51 survivors (mean age=55 years) with elevated Insomnia Severity Index (ISI) scores (>=12) first received a single, hour-long sleep education session, and were reassessed 1-month later. Those continuing to report elevated ISI scores (>=12) were then offered a 3-session cognitive-behavioral treatment for insomnia (CBT-I) program that we previously demonstrated to be efficacious in cancer survivors. Participants were considered "treatment responders" if their ISI score improved by >=6 points, and considered "remitted" if their post-treatment ISI score was <12. Mood was assessed with the Profile of Mood States (POMS). Result(s): Following the single sleep education session, mean ISI scores improved (17.1 to 11.2; p