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Sleep without drugs

Study shows cancer-related insomnia can be treated without medication

Research

By Kelly Foss

A study conducted by a team from Memorial Sloan Kettering Cancer Center and the University of Pennsylvania, and including a Memorial University researcher, has found that cancer-related insomnia can be effectively treated without medication.

The study, titled CHoosing Options for Insomnia in Cancer Effectively (CHOICE): A Comparative Effectiveness Trial of Acupuncture and Cognitive Behavioral Therapy, was published April 9, in the Journal of the National Cancer Institute.

It’s considered the source for the most up-to-date information from the fields of cancer research and treatment.

No side effects

“Although insomnia is a common and debilitating disorder that affects up to 60 per cent of cancer survivors, it is under recognized and under treated,” said Dr. Sheila Garland, a clinical psychologist and the director of Memorial University’s Sleep, Health and Wellness Lab.

“Drug treatment for insomnia can have a lot of side effects, such as sedation, dependence and falls. Patients want to improve their sleep without the use of drugs.”

The team conducted a randomized trial comparing eight weeks of acupuncture and cognitive behavioural therapy for insomnia (CBT-I) in cancer survivors. Both treatments produced clinically meaningful reductions in insomnia severity which persisted over time – up to 20 weeks or three months without therapy.

CBT-I was more effective overall than acupuncture post-treatment. It was also more effective for those who were male, white, highly educated and who had no pain when they began the study. Between acupuncture and CBT-I, the comparative benefit is not significantly different for those who are female or with lower education.

Largest and most-diverse study

“Acupuncture was more effective than CBT-I for pain in the short term,” said Dr. Garland. “However, both treatments had similar improvements for fatigue, mood, quality of life and reduced prescription hypnotic medication use.”

This is the first head-to-head comparison trial of acupuncture versus CBT-I for insomnia and the largest randomized trial of acupuncture for insomnia conducted in cancer survivors.

It also represented the most diverse group of cancer survivors as most prior trials only enrolled breast cancer survivors. Close to 30 per cent of the participants in this study were from minority groups and included people with many different types of cancer.

The results of this study increase the evidence for both acupuncture and CBT-I as treatment options for insomnia.


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