Cognitive behavioral therapy more effective than acupuncture for insomnia in cancer survivors
medwireNews: Trial results suggest that cognitive behavioral therapy for insomnia (CBT-I) is more effective than acupuncture for reducing the severity of insomnia symptoms in cancer survivors, although both approaches offer benefits.
A total of 160 individuals who had completed treatment for cancer diagnosed an average of 6 years previously and had insomnia (mild in 20.6%; moderate or severe in 79.4%) were randomly assigned to receive CBT-I – which involved sleep restriction, stimulus control, cognitive restructuring, relaxation training, and education – or acupuncture for 8 weeks.
At this timepoint, average Insomnia Severity Index improved from baseline by 10.9 points in the CBT-I group, falling from 18.5 to 7.5 points, and by 8.3 points in the acupuncture group, from 17.6 to 9.2 points, a significant difference.
Among participants with mild insomnia, CBT-I was associated with a significantly higher rate of response than acupuncture at the 8-week mark, with rates of 85% and 18%, respectively.
By contrast, the response rates were comparable between groups for individuals with moderate or severe symptoms, at 75% for CBT-I and 66% for acupuncture, presenting author Jun Mao (Memorial Sloan Kettering Cancer Center, New York, USA) told press at a briefing prior to the ASCO Annual Meeting 2018, held in Chicago, Illinois, USA.
Study participants in both groups also reported improvements in their quality of life, in terms of the physical health and mental health components of the PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaire, with no significant differences between treatment arms.
The improvements in insomnia symptoms were maintained in the CBT-I and acupuncture groups up to the 20-week assessment.
Mao summarized: “While both acupuncture and CBT-I resulted in clinically meaningful and durable effects among cancer survivors with insomnia, CBT-I was more effective, especially among patients with mild insomnia symptoms.
“Patients and oncology clinicians can use these findings to inform their choice of insomnia treatment,” he concluded.
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