Need Sleep? Interventions for Healthful Sleep
Cancer is a complex illness that often carries a significant burden of side effects for patients, who are today experiencing an increased number of years in survivorship. Insomnia (i.e. trouble falling asleep, maintaining sleep, early morning awakenings and non-restorative sleep), is prevalent in patients with cancer and their caregivers and often goes undertreated. Insomnia impacts quality of life and also has the potential to interfere with immune functioning and patient treatment outcomes (Lis, C.G., Gupta, D., and Grytsch, J.F., 2008). Causes of insomnia include dysfunctional beliefs about sleep, fears, ruminating thoughts, and maladaptive behaviors. Cognitive behavioral therapy for insomnia (CBT-I) has been shown to be an effective intervention for sleep disturbance, and can be preferable to pharmacotherapy, which is often associated with side effects (Perlis, M.L., Jungquist, C., Smith, M.T., & Posner, D., 2008). Need Sleep? was created as a multi-component, structured, cognitive behavioral program for patients and caregivers who identify sleep disturbance as a problem, but have not been diagnosed with a sleep disorder. Session content includes education on insomnia and the role of dysfunctional beliefs about sleep, ruminating thoughts and fears. Information on sleep hygiene and relaxation techniques are also provided and the concepts of sleep restriction and stimulus control are discussed. Weekly sleep diaries are used both as a learning tool and as a way to calculate sleep efficiency. In session worksheets and homework assignments serve to reinforce learning. Such evidence based interventions have the potential to increase quality of life and reduce negative health outcomes. Oncology social workers would benefit from learning a protocol, such as "Need Sleep?" which would provide them with strategies to better assist patients and caregivers experiencing insomnia.
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