TY - JOUR
T1 - The effect of online cognitive behavioral therapy for insomnia in adolescents and young adults after childhood cancer
T2 - Results from a randomized controlled trial
AU - van der Hoek, Hinke
AU - Peersmann, Shosha H.M.
AU - Maurice-Stam, Heleen
AU - Kaspers, Gertjan J.L.
AU - van den Bergh, Esther M.M.
AU - Tissing, Wim J.E.
AU - Kremer, Leontien C.M.
AU - Abbink, Floor
AU - de Vries, Andrica C.H.
AU - Loonen, Jacqueline
AU - van Straten, Annemieke
AU - Grootenhuis, Martha A.
AU - van Litsenburg, Raphaële R.L.
N1 - Publisher Copyright:
© 2025 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.
PY - 2025/3/15
Y1 - 2025/3/15
N2 - Background: Insomnia is common during and after childhood cancer and associated with negative health outcomes and impaired quality of life. Many adolescents and young adults do not receive treatment. Internet-delivered cognitive behavioral therapy for insomnia (iCBT-i) can fill this gap. This study assesses the effectiveness of the iCBT-i intervention “iSleep youth”. Methods: Patients (12–30 years old) with an Insomnia Severity Index ≥8, ≥6 months after treatment, and <10 years after diagnosis were 1:1 randomized to iSleep youth or the wait list-control group. iSleep youth consists of five online sessions with a coach. Outcomes were sleep efficiency (actigraph-based), insomnia, fatigue, and health-related quality of life (HRQOL). Differences over time between iSleep youth and controls, 3 months (T3) and 6 months (T6) from baseline, were assessed with linear mixed models, controlling for age, sex, and time since end of treatment. iSleep youth also had a follow-up measurement after 12 months (T12). Results: Fifty-four (response rate, 49%) patients participated: 68.9% females, mean age, 18.5 years (SD = 3.5), and mean time since end of treatment 3.8 years (SD = 2.3). No significant effects between the two groups were found for sleep efficiency. However, iSleep youth had a beneficial effect on insomnia severity at T3 (β = –0.79) and T6 (β = –0.55), on fatigue at T3 (β = –1.08) and T6 (β = –0.52) and on HRQOL at T3 (β = 0.46) and T6 (β = 0.62). The scores did not change from T6 to T12 in iSleep youth. Conclusions: iSleep youth is effective in treating insomnia and concurrent fatigue in adolescents and young adults after childhood cancer and should be implemented.
AB - Background: Insomnia is common during and after childhood cancer and associated with negative health outcomes and impaired quality of life. Many adolescents and young adults do not receive treatment. Internet-delivered cognitive behavioral therapy for insomnia (iCBT-i) can fill this gap. This study assesses the effectiveness of the iCBT-i intervention “iSleep youth”. Methods: Patients (12–30 years old) with an Insomnia Severity Index ≥8, ≥6 months after treatment, and <10 years after diagnosis were 1:1 randomized to iSleep youth or the wait list-control group. iSleep youth consists of five online sessions with a coach. Outcomes were sleep efficiency (actigraph-based), insomnia, fatigue, and health-related quality of life (HRQOL). Differences over time between iSleep youth and controls, 3 months (T3) and 6 months (T6) from baseline, were assessed with linear mixed models, controlling for age, sex, and time since end of treatment. iSleep youth also had a follow-up measurement after 12 months (T12). Results: Fifty-four (response rate, 49%) patients participated: 68.9% females, mean age, 18.5 years (SD = 3.5), and mean time since end of treatment 3.8 years (SD = 2.3). No significant effects between the two groups were found for sleep efficiency. However, iSleep youth had a beneficial effect on insomnia severity at T3 (β = –0.79) and T6 (β = –0.55), on fatigue at T3 (β = –1.08) and T6 (β = –0.52) and on HRQOL at T3 (β = 0.46) and T6 (β = 0.62). The scores did not change from T6 to T12 in iSleep youth. Conclusions: iSleep youth is effective in treating insomnia and concurrent fatigue in adolescents and young adults after childhood cancer and should be implemented.
UR - http://www.scopus.com/inward/record.url?scp=86000336987&partnerID=8YFLogxK
U2 - 10.1002/cncr.35796
DO - 10.1002/cncr.35796
M3 - Article
C2 - 40045689
AN - SCOPUS:86000336987
SN - 0008-543X
VL - 131
JO - Cancer
JF - Cancer
IS - 6
M1 - e35796
ER -
