Factors associated with significant improvement in cancer-related fatigue after completing cognitive behavioral therapy for insomnia in cancer survivors
Menée au Canada à partir de données portant sur 121 patients ayant survécu à un cancer et bénéficié d'une psychothérapie comportementale, cette étude identifie des facteurs associés à la réduction des symptômes de fatigue et d'insomnie liés au cancer
Purpose: Cancer-related fatigue (CRF) can be a persistent and severe consequence of cancer treatment. Cognitive behavioral therapy for insomnia (CBT-I) can improve CRF in those with insomnia comorbid with cancer. This secondary analysis of a randomized controlled trial investigated what proportion of participants benefit and the factors associated with an improvement in CRF following CBT-I.
Methods: Atlantic Canadian cancer survivors (N = 121) with insomnia disorder and perceived cognitive impairment symptoms were recruited to participate in a randomized controlled trial of CBT-I. Fatigue was measured using the Multidimensional Fatigue Symptom Inventory–Short Form. Univariable and multivariable binary logistic regressions were used to assess clinical, symptom, and demographic factors associated with a significant improvement in CRF after CBT-I.
Results: The majority (75%) of the sample (Mage = 60.12 years, 77% women, 45% breast cancer) experienced a significant reduction in CRF symptoms following the intervention. Being younger (under 55), being female, having anxiety, and undergoing chemotherapy were associated with a greater likelihood of improvement in CRF at the univariable level. At the multivariable level, only younger age was significantly associated with an improvement in CRF after CBT-I.
Conclusion: CBT-I can effectively reduce CRF in cancer survivors who also experience insomnia. Differences in sleep patterns and/or the number of comorbid physical health concerns between younger and older people may explain why CBT-I improved CRF more in younger participants. Future research is needed to better understand the demographic, symptom, and clinical variables that may influence treatment response.
Supportive Care in Cancer , résumé 2025