Cognitive Behavioral Therapy Compared With Acupuncture for Insomnia in Cancer Survivors

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Investigators sought to determine whether cognitive behavioral therapy or acupuncture was more effective in addressing insomnia in this population.
Investigators sought to determine whether cognitive behavioral therapy or acupuncture was more effective in addressing insomnia in this population.
The following article features coverage from the American Society of Clinical Oncology (ASCO) 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Cognitive behavioral therapy for insomnia (CBT-I) may lead to more clinically meaningful and sustained improvements among cancer survivors with insomnia compared with acupuncture, according to data that will be presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois, on Sunday, June 3.1

Nearly 60% of cancer survivors suffer from insomnia, a debilitating condition that severely affects patients' quality of life. Investigators sought to determine whether CBT-I or acupuncture was more effective in addressing insomnia in this population.

In the Choosing Options for Insomnia in Cancer Effectively (CHOICE) study (ClinicalTrials.gov Identifier: NCT02356575), researchers randomly assigned 160 survivors diagnosed with insomnia disorder to receive acupuncture or CBT-I. Patients assigned to acupuncture had thin needles inserted under the skin to treat different symptoms and illnesses. CBT-I consists of cognitive restructuring, relaxation training, stimulus control, sleep restriction, and education.

Participants underwent an 8-intervention, and had a follow-up assessment after 20 weeks. The Insomnia Severity Index was used to assess insomnia.

Results showed that insomnia severity score was reduced by 10.9 compared with 8.3 points in the CBT-I group and acupuncture group, respectively. CBT-I was found to be significantly more effective overall for insomnia (2.6, 95% CI, 1.1-4.1; P = .0007) compared with acupuncture.

CBT-I led to a significantly higher rate of response among patients with mild insomnia versus acupuncture (85% vs 18%; P < .0001), but there were no significant differences in response to either treatment among patients with moderate-to-severe insomnia (75% vs 66%; P = .26).

The treatment was well tolerated and associated with few mild side effects, and improvements were maintained for up to 20 weeks. Both patient groups experienced similar benefits in physical and mental quality of life.

Findings of the study show that although both acupuncture and CBT-I improved insomnia among survivors, CBT-I may be more effective, particularly among patients with mild insomnia. The authors concluded that “patients and oncology clinicians can use these findings to inform their choice of insomnia treatment.”

Read more of Cancer Therapy Advisor's coverage of the American Society of Clinical Oncology (ASCO) 2018 meeting by visiting the conference page.

Reference

  1. Mao JJ, Xie S, Duhamel K, et al. The effect of acupuncture versus cognitive behavior therapy on insomnia in cancer survivors: a randomized trial. Oral presentation at: 2018 ASCO Annual Meeting; June 1-5, 2018; Chicago, IL.

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