Abstract

Purpose: To determine 1-year outcomes of a four-component behavioral therapy (BT) sleep intervention (Individualized Sleep Promotion Plan [ISPP]) versus a healthy eating control (HEC) on cancerrelated fatigue in women receiving breast cancer adjuvant chemotherapy treatment (CTX). Patients and Methods: A total of 219 participants from 12 oncology clinics were randomly assigned in a clinical trial. Before CTX, research nurses coached intervention participants to develop a BT plan including stimulus control, modified sleep restriction, relaxation therapy, and sleep hygiene. BT plans were revised before each CTX and 30, 60, and 90 days after the last CTX and reinforced 7 to 9 days later. HEC participants received nutritional information and equal attention. Pittsburgh Sleep Quality Index (PSQI), Daily Diary, Wrist Actigraph, and Piper Fatigue Scale measures and Repeated Linear Mixed Model analysis following the Intent to Treat paradigm were used. Results: Sleep quality differed over 1 years time (F [4,162] = 7.7, P < .001; by group, F [1,173] = 4.8, P = .029; and over time by group, F [4,162] = 3.3, P = .013). Pairwise comparisons revealed significant differences between groups at 90 days (P = .002) but not at 1 year (P = .052). Seven days of diary and actigraphy data did not corroborate with monthly reflections (PSQI). The night awakenings (Actigraph) pattern was significantly different by group over time (P = .046), with no differences between groups at 90 days or at 1 year. Fatigue was lower at 1 year than before CTX; no group effects were found. Conclusion: The BT group, on average, experienced significant improvement on global sleep quality compared with the HEC group, but not on objective sleep or fatigue outcomes.

Original languageEnglish (US)
Pages (from-to)6033-6040
Number of pages8
JournalJournal of Clinical Oncology
Volume27
Issue number35
DOIs
StatePublished - Dec 10 2009

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Fatigue
Sleep
Neoplasms
Therapeutics
Actigraphy
Piper
Relaxation Therapy
Adjuvant Chemotherapy
Group Psychotherapy
Wrist
Linear Models
Nurses
Clinical Trials
Breast Neoplasms
Control Groups
Research
Healthy Diet

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

One-year outcomes of a behavioral therapy intervention trial on sleep quality and cancer-related fatigue. / Berger, Ann Malone; Kuhn, Brett R; Farr, Lynne A.; Von Essen, Susanna G; Chamberlain, Julie; Lynch, James C.; Agrawal, Sangeeta.

In: Journal of Clinical Oncology, Vol. 27, No. 35, 10.12.2009, p. 6033-6040.

Research output: Contribution to journalArticle

Berger, Ann Malone ; Kuhn, Brett R ; Farr, Lynne A. ; Von Essen, Susanna G ; Chamberlain, Julie ; Lynch, James C. ; Agrawal, Sangeeta. / One-year outcomes of a behavioral therapy intervention trial on sleep quality and cancer-related fatigue. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 35. pp. 6033-6040.
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abstract = "Purpose: To determine 1-year outcomes of a four-component behavioral therapy (BT) sleep intervention (Individualized Sleep Promotion Plan [ISPP]) versus a healthy eating control (HEC) on cancerrelated fatigue in women receiving breast cancer adjuvant chemotherapy treatment (CTX). Patients and Methods: A total of 219 participants from 12 oncology clinics were randomly assigned in a clinical trial. Before CTX, research nurses coached intervention participants to develop a BT plan including stimulus control, modified sleep restriction, relaxation therapy, and sleep hygiene. BT plans were revised before each CTX and 30, 60, and 90 days after the last CTX and reinforced 7 to 9 days later. HEC participants received nutritional information and equal attention. Pittsburgh Sleep Quality Index (PSQI), Daily Diary, Wrist Actigraph, and Piper Fatigue Scale measures and Repeated Linear Mixed Model analysis following the Intent to Treat paradigm were used. Results: Sleep quality differed over 1 years time (F [4,162] = 7.7, P < .001; by group, F [1,173] = 4.8, P = .029; and over time by group, F [4,162] = 3.3, P = .013). Pairwise comparisons revealed significant differences between groups at 90 days (P = .002) but not at 1 year (P = .052). Seven days of diary and actigraphy data did not corroborate with monthly reflections (PSQI). The night awakenings (Actigraph) pattern was significantly different by group over time (P = .046), with no differences between groups at 90 days or at 1 year. Fatigue was lower at 1 year than before CTX; no group effects were found. Conclusion: The BT group, on average, experienced significant improvement on global sleep quality compared with the HEC group, but not on objective sleep or fatigue outcomes.",
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AU - Berger, Ann Malone

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AU - Chamberlain, Julie

AU - Lynch, James C.

AU - Agrawal, Sangeeta

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N2 - Purpose: To determine 1-year outcomes of a four-component behavioral therapy (BT) sleep intervention (Individualized Sleep Promotion Plan [ISPP]) versus a healthy eating control (HEC) on cancerrelated fatigue in women receiving breast cancer adjuvant chemotherapy treatment (CTX). Patients and Methods: A total of 219 participants from 12 oncology clinics were randomly assigned in a clinical trial. Before CTX, research nurses coached intervention participants to develop a BT plan including stimulus control, modified sleep restriction, relaxation therapy, and sleep hygiene. BT plans were revised before each CTX and 30, 60, and 90 days after the last CTX and reinforced 7 to 9 days later. HEC participants received nutritional information and equal attention. Pittsburgh Sleep Quality Index (PSQI), Daily Diary, Wrist Actigraph, and Piper Fatigue Scale measures and Repeated Linear Mixed Model analysis following the Intent to Treat paradigm were used. Results: Sleep quality differed over 1 years time (F [4,162] = 7.7, P < .001; by group, F [1,173] = 4.8, P = .029; and over time by group, F [4,162] = 3.3, P = .013). Pairwise comparisons revealed significant differences between groups at 90 days (P = .002) but not at 1 year (P = .052). Seven days of diary and actigraphy data did not corroborate with monthly reflections (PSQI). The night awakenings (Actigraph) pattern was significantly different by group over time (P = .046), with no differences between groups at 90 days or at 1 year. Fatigue was lower at 1 year than before CTX; no group effects were found. Conclusion: The BT group, on average, experienced significant improvement on global sleep quality compared with the HEC group, but not on objective sleep or fatigue outcomes.

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