Did you know that many cancer patients and survivors have sleep problems? Several things affect sleeping habit, including medications that treat cancer, duration of stay at the hospital, and psychological stress experienced. In such cases, CBT (or cognitive behavioral therapy) is a great way to improve sleep patterns.
Sleep-related problems in cancer patients may be similar to those in the general. Cancer can make your daily life upside down and also your sleep. Before the diagnosis, someone may have had a fixed time to wake up and go to bed. However, people with cancer may take a nap or wake up with anxiety or pain at night. People with cancer may not be able to sleep because of the side effects of treatments such as chemotherapy.
Through cognitive-behavioral therapy (CBT) for insomnia, patients learn to recognize and replace sleep-disturbing thoughts and behaviors with healthier ones.
The habits of disturbing sleep and causing insomnia
It’s like waking up in bed and spending a lot of time watching TV or playing games. You don’t have to sit in a dark room an hour before bedtime, but it’s important to avoid or minimize the blue light from your device. Also, some people with insomnia have no downtime. Patients may try to make an hour or two hours of buffer to do something relaxing. Alcohol doesn’t help. It may make you fall asleep sooner, but it can confuse your sleep.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy incorporates cognitive and behavior modification techniques to address a patient’s dysfunctional attitudes and sleep patterns. It’s a psychotherapeutic treatment that focuses on how our thoughts affect our overall mood and emotional state of mind.
It is in use to treat many mental disorders since a long time. Recently, it can be useful in treating the pain associated with cancer, the treatment of various types of cancer, and their overall psychological burden.
Components of CBT-I
Cognitive Behavioral Therapy for Insomnia (CBT-I) is a multi-component intervention. It target the specific cognitive, physiological, and behavioral aspects that characterize insomnia. CBT-I contains five elements such as stimulus control, sleep restriction, sleep hygiene, cognitive remodeling, and relaxation training.
Sleep Restriction: This protocol aims to control how much time you spend in bed to accurately match your sleep time, and to improve your sleep quality by increasing your sleep time. Sleep restriction helps to get quality sleep, make the time you spend sleeping more efficient, and aim for a sleep efficiency of 85% to 90%.
Stimulus control: These are situations in which the presence or absence of a particular stimulus triggers a particular behavior. For example, if you eat while watching TV, you will be hungry every time you turn on the TV. Stimulus control techniques are unlikely to work well unless practiced consistently. Reconditioning can take a long time, so each technique should take at least a week or two before you notice any changes in your sleep.
Cognitive Reconstruction: This is a psychotherapeutic process in which patients readjust their emotional responses to specific objects, resulting in all-or-nothing thinking (splitting), over-generalization, problem expansion, and emotions. You can recognize and challenge irrational or maladaptive thinking, such as thinking.
Relaxation training and education: This includes methods and activities that help a person relax, stay calm, and reduce general pain, anxiety, stress, and anger levels. We achieve this is through practices such as meditation and listening to soothing music. Individuals can train in different types of relaxation techniques such as guided imagery, diaphragmatic breathing, progressive muscle relaxation, and passive progressive muscle relaxation. Patients should practice these techniques at home since they can help promote a state of rest to help the individual relax and fall asleep.
Effectiveness of CBT in cancer patients
In the past, cancer patients suffering from insomnia have had treatments such as acupuncture. However, recent research results show that CBT-I (or cognitive-behavioral therapy for insomnia) is far more effective than acupuncture. It is especially effective in reducing the severity of insomnia, which is common in cancer patients.
In one such study, in which patients were affected by insomnia ranging from mild to severe. Some patients were treated with CBT-I, and others received traditional acupuncture. To eliminate any kind of prejudice from this process, patients were randomly selected and received either treatment. In this test, CBT-I worked 34 percent better than acupuncture.
Although CBT is an effective and long-term treatment for chronic insomnia, the evidence for CBT has not changed its practice so far. It remains unclear how insomniac CBT can be integrated into existing tumor treatment settings, especially when it is most beneficial to patients.
However, keep in mind that availability is the main barrier to integrating CBT for insomnia into practice. Therapist availability, geographic distance, and financial resources impact can limit patient access to treatment.
In recent years, several treatment models for CBT for insomnia have been developed. This offers the potential for a step-by-step care model that may be key to facilitating the integration of insomnia treatment into a wider range of cancer services. Future studies need to focus on improving the treatment of severe and invasive sleep disorders common to cancer by identifying the most appropriate methods for providing CBT interventions to these patients.