Randomized trial of cognitive behavioral therapy for insomina to address perceived cancer-related cognitive impairment in cancer survivors

Comorbid insomnia and cancer-related cognitive impairment (CRCI) are experienced by up to 26% of cancer patients. A randomized study in Canada examined the efficacy of cognitive behavioral therapy for insomina (CBT-I) on perceived CRCI in cancer survivors. Survivors with insomnia and CRCI were randomized to seven weekly online CBT-I sessions or a waitlist control group. After two months the treatment group reported significantly better reduction in insomnia severity than the control group (p<0.001). The treatment group had a greated overall improvement than the waitlist control on perceived cognitive impairment (p<0.001), cognitive abilities (p<0.001), and impact on quality of life (p<0.001). These improvements were maintained at 3 and 6 months follow-up. Change in insomnia fully mediated the effect of CBT-I on subjective cognitive outcomes. The authors conclude that treating insomnia with CBT-I produced clinically meaningful and durable improvements in CRCI.