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Serious about sleep

Patient co-investigators, members report cognitive therapy improves memory


By Kelly Foss

As if having cancer wasn’t hard enough, nearly 20 per cent of cancer survivors who have issues falling or staying asleep also have trouble remembering things, paying attention and concentrating.

A male and three females. Two are seated in armchairs and two are sitting on the chair arms.
From left are Bob Wakeham, study participant; Dr. Sheila Garland, assistant professor of psychology and oncology; Kathryn Dalton, research co-ordinator; and Sondria Brown, patient co-investigator.
Photo: Rich Blenkinsopp

That’s according to research by Dr. Sheila Garland, associate professor of psychology and oncology at Memorial University and a clinical psychologist.

International attention

There are few effective treatments to improve cognition after cancer.

However, improving your sleep using cognitive behavioural therapy for insomnia (CBT-I) can help, according to recent findings of the Addressing Cancer Treatment-Related Insomnia Online in Atlantic Canada (ACTION) study.

Headed by Dr. Garland, the study demonstrates for the first time that treating insomnia in cancer patients can improve cognition.

“[ACTION] would have saved me countless nights of lost sleep and the effect of this on my ability to function.” — Sondria Browne

It also garnered international attention at the world’s premier clinical and scientific meeting for sleep medicine, sleep and circadian research, and sleep health in Indianapolis, Ind., from June 3-7.

Seventy-three participants from Newfoundland and Labrador and 59 participants from the remaining Atlantic provinces were recruited for the study.

All the individuals experienced insomnia for at least three months and reported difficulty with memory, concentration and attention.

A woman with blurred scenery behind her.
Dr. Sheila Garland
Photo: Rich Blenkinsopp

After completing the seven-week treatment program, the ACTION participants reported clinically significant improvements in their cognition.

“After I got my sleep back on track, I found that I could think more clearly,” said one participant. “I was no longer forgetting the simple things, like where I placed my keys.”

Treating sleep problems

Dr. Garland says sleep problems often start after a cancer diagnosis for many reasons, including worries about cancer, changes to your routine and side effects of treatment.

“CBT-I is recommended as the first-line treatment for insomnia and targets the thoughts, behaviours and emotions that make it hard for people to sleep,” she said. “People who have been treated for cancer are 2-3 times more likely to experience insomnia and this negatively impacts practically all other areas of their lives.”

Dr. Garland says that cognitive impairment is a big reason why people who have been treated for cancer find it hard to return to work.

“The psychological repercussions of cancer can be equally devastating, if not worse, than the physical impacts.” — Bob Wakeham

If they don’t sleep well at night, individuals with cancer may find it challenging to function the next day.

Sondria Browne, a patient co-investigator on the study, was diagnosed with breast cancer.

She says she knows how it feels to not be able to sleep and its impact on your cognitive abilities.

“I wish the ACTION study was available when I needed it,” she said. “It would have saved me countless nights of lost sleep and the effect of this on my ability to function the next day.”

Bob Wakeham, a patient member of the trial steering committee, was diagnosed with colon cancer.

He received CBT-I from Dr. Garland and also knows first-hand how important sleep is to cancer recovery.

“The psychological repercussions of cancer can be equally devastating, if not worse, than the physical impacts, and that includes debilitating insomnia,” he said.

Mr. Wakeham says the treatment from Dr. Garland and her team has had a profound effect on his psychological well-being.

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