Behavioral Interventions for Sleep Problems in Cancer Patients: A Primer and Narrative Review of Evidence, Implementation Considerations, and Future Directions

This narrative review summarizes the evidence for behavioral interventions addressing sleep disturbance (i.e., insomnia) in cancer populations. Implementation considerations and future research directions are provided.

Support is strong for Cognitive Behavioral Therapy for Insomnia (CBTI) in cancer populations. Mindfulness and acceptance-based therapies show promise for improving sleep disturbance, especially when integrated with sleep restriction and stimulus control; however, comparative efficacy to CBTI should be further investigated. Psychologists most commonly deliver behavioral insomnia interventions. Recent work shows other clinicians (e.g., nurses) can also deliver these treatments, and this shift may improve the shortage of behavioral sleep providers in the oncology setting.

CBTI is the “gold standard” for treating insomnia in cancer patients. Future research should expand its focus beyond breast cancer samples and examine stepped care models that leverage digital technologies (e.g., mobile applications, wearables) to address access and resources barriers limiting clinical implementation.