Improve Sleep in Breast Cancer Patients with Mindfulness
By John M. de Castro, Ph.D.
“That MBSR [mindfulness-based stress reduction] can produce similar improvements to CBT-I [cognitive behavioral therapy for insomnia] and that both groups can effectively reduce stress and mood disturbance expands the available treatment options for insomnia in cancer patients,” – Sheila Garland
Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue and insomnia. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.
But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day. It is estimated that nearly a third of breast cancer survivors have major disturbances of sleep that adds to the stress and damages recovery.
Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress, sleep disturbance, and anxiety and depression. In today’s Research News article “Cognitive Behavioral Therapy for Insomnia, Mindfulness, and Yoga in Patients with Breast Cancer with Sleep Disturbance: A Literature Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802619/ ), Zeichner and colleagues review and summarize the published research literature on the application of mindfulness training, yoga, and Cognitive Behavioral Therapy for Insomnia (CBT-I) for the treatment of sleep disturbance in breast cancer patients.
They report that the research demonstrates that all three approaches are effective in reducing sleep disturbance in breast cancer patients with efficacies equivalent to those of drug treatments but with fewer adverse side effects. They report that Cognitive Behavioral Therapy for Insomnia (CBT-I) has been more consistently shown to be effective than mindfulness training or yoga practice. But CBT-I has greater problems with long-term patient compliance, greater costs, and a relative lack of service providers. Mindfulness training particularly Mindfulness-Based Stress Reduction (MBSR) programs and yoga practice are effective in relieving insomnia and are lower cost, higher compliance, and more available options.
So, improve sleep in breast cancer patients with mindfulness.
“Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients. Scientists caution, however that sustained benefit requires ongoing mindfulness practice.” – Breast Cancer Research Foundation
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Simon B Zeichner, Rachel L Zeichner, Keerthi Gogineni, Sharon Shatil, Octavian Ioachimescu. Cognitive Behavioral Therapy for Insomnia, Mindfulness, and Yoga in Patients With Breast Cancer with Sleep Disturbance: A Literature Review. Breast Cancer (Auckl) 2017; 11: 1178223417745564. Published online 2017 Dec 7. doi: 10.1177/1178223417745564
Abstract
The number of patients with breast cancer diagnosed with sleep disturbance has grown substantially within the United States over the past 20 years. Meanwhile, there have been significant improvements in the psychological treatment of sleep disturbance in patients with breast cancer. More specifically, cognitive behavioral therapy for insomnia (CBT-I), mindfulness, and yoga have shown to be 3 promising treatments with varying degrees of benefit, supporting data, and inherent limitations. In this article, we will outline the treatment approach for sleep disturbance in patients with breast cancer and conduct a comprehensive review of CBT-I, mindfulness, and yoga as they pertain to this patient population.
Conclusions
Breast cancer is the most commonly diagnosed cancer in women and sleep disturbance is one of the most common complaints among women with this diagnosis. Interventions to improve sleep could improve QOL and productivity and could reduce comorbidities and decrease use of health care resources. Cognitive behavioral therapy for insomnia, mindfulness, and yoga are 3 behavioral health interventions that have been recommended in the treatment of sleep disturbance in patients with cancer. Depending on cancer disease severity, nonpharmacologic approaches may be more beneficial because efficacy appears to be similar to pharmacological approaches, patients can continue to implement behavioral strategies long after active treatment has ended, and there are fewer adverse effects.