1012 A DANISH LANGUAGE INTERNET-DELIVERED INTERVENTION FOR INSOMNIA IN CANCER SURVIVORS: EFFECTS ON CANCER-RELATED FATIGUE

Abstract

Introduction: Sleep difficulties and cancer-related fatigue (CRF) are common co-occurring symptoms associated with breast cancer treatment. Approximately 40% of breast cancer survivors report clinical levels of CRF. Although sleep problems and fatigue are distinct symptoms, they may be reciprocally related, and thus, treatment for one symptom may impact the other. Cognitive-behavioral therapy for insomnia (CBT-I) has been shown to be a highly effective intervention for individuals with insomnia, but is not widely available due to expense, time constraints, and lack of trained professionals. The Internet, however, has been shown to be feasible for delivering CBT-I. Here we present secondary analyses from a randomized trial investigating the potential efficacy of an Internet-delivered CBT-I to reduce symptoms of CRF in cancer survivors, comparing an intervention group with a wait-list control group. Methods: 255 Danish breast cancer survivors experiencing significant sleep problems were randomized to the SHUTi (N=133) and waitlist control (N=122) conditions, and 201 and 195 participants completed post-treatment and 6-month follow-up assessments respectively. Sleep quality was measured with the Pittsburg Sleep Quality Index (PSQI); Insomnia with the Insomnia Severity Index (IS); and Fatigue with the FACIT Fatigue Scale (FFS). Results: At baseline, 38% of all participants had clinical levels of CRF (FFS below 34). A repeated measure GLM analyses showed statistically significant group x time interaction effects for both insomnia severity (ISI) (p<0.001; Cohen's d=1.39], sleep quality (PSQI) (p<0.001; d=0.98], as well as CRF (FFS) (p<0.0001; Cohen's d = 0.64]. At the 6-month follow up, only 12 % of the intervention group had clinical levels of CRF compared to 31% in the wait-list control group (p<0.05). Conclusion: These findings provide further evidence for web-based programs to be considered as an important means to reducing the burden of both insomnia and fatigue in cancer survivors.