focused on patients living with metastatic cancer. We examined the feasibility of the SleepNow intervention combining cognitive behavioral therapy for insomnia (CBT-I) with physical exercise in men with metastatic prostate cancer (mPCa).
We conducted a feasibility randomized trial in patients under treatment for castration resistant mPCa with insomnia (Insomnia Severity Index [ISI] score ≥ 8). Patients were randomized 1:1 to either SleepNow or usual care. SleepNow is a manualized 12-week program consisting of bi-weekly sessions of physical exercise and four nurse-led sessions of CBT-I. Patients in usual care received no insomnia treatment. We assessed feasibility and measured objective and patient-reported outcomes at baseline and 3-months follow-up. Changes in both groups were compared using the Wilcoxon test.
We randomized 12 patients (5 intervention and 7 control; age range = 59-81 years, mean Gleason score = 7.75, mean time since diagnosis ≈ 7 years). Intervention patients reported high satisfaction, all attended at least three CBT-I sessions (75%) and four completed at least 20 of the 24 training sessions. The intervention group showed improvements in insomnia, sleep quality, fatigue, anxiety, depression and health-related quality-of-life but between-group differences were not statistically significant.
The SleepNow intervention is the first to combine nurse-delivered CBT-I and physical exercise and was acceptable and potentially efficacious. Our results are important for targeting sleep interventions to the growing population of patients living long term with metastatic cancer.
Acta oncologica (Stockholm, Sweden). 2025 Feb 09*** epublish ***
Beverley Lim Høeg, Katrine Bjerre Løppenthin, Josée Savard, Christoffer Johansen, Jesper Frank Christensen, Mads Nordahl Svendsen, Niels Holländer, Pernille Envold Bidstrup
Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark. ., Phase 1 Unit, Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark., School of Psychology, Faculty of Social Sciences, Université Laval and CHU de Québec-Université Laval Research Center, Québec, Canada., CASTLE, Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark., Center for Physical Activity Research, Copenhagen University Hospital, Denmark., Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark., Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark; Department of Psychology, Copenhagen University, Copenhagen, Denmark.