![]() Insomnia seems to be determined by predisposing, precipitating, and perpetuating factors ( Spielman et al., 1987 American Psychiatric Association, 1994 Bastien et al., 2004). It has a high prevalence in women with breast cancer for several reasons, such as a general increase in psychological distress after the cancer diagnosis and disruption of sleep due to increased frequency and severity of hot flushes caused by menopause, often induced by the chemotherapy ( Fiorentino et al., 2010). Notwithstanding the wide spread of the phenomenon in this population, insomnia is largely understudied. It has been estimated that ~30–60% of breast cancer women experience insomnia and the prevalence is higher than in non-cancer patients ( Savard et al., 2009 Palesh et al., 2010). Patients with the diagnosis of breast cancer report very often insomnia ( Ohayon, 2002). Insomnia also involves subjective reports of daytime symptoms such as fatigue or low energy, difficulties with cognitive functions, for instance attention, concentration, and memory, and mood disturbances including irritability and dysphoria, all of which can produce functional impairment and are often the primary concerns pushing patients to seek treatment. Insomnia is characterized by subjective complaints about dissatisfaction with sleep quality or duration, difficulty falling asleep at bedtime, waking up too early in the morning or in the middle of the night, or non-restorative, or poor quality sleep. Insomnia is defined by the International Classification of Sleep Disorders, third edition ( American Academy of Sleep Medicine, 2014) as “a persistent difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity and circumstances for sleep, and results in some form of daytime impairment.” ![]() Improvements concerning insomnia and sleep quality are durable (usually up to 12 months) and statistically significant. CBT-I may also reduce menopausal symptoms, such as hot flushes and night sweat problems, frequency of medicated nights, level of depression, and anxiety.Ĭonclusions: CBT-I seems to be an eligible intervention for improving sleep in BCS. ![]() CBT-I appears to be an effective therapy for insomnia in BCS, improving mood, general and physical fatigue, and global and cognitive dimensions of quality of life. Results: A total of 16 studies were found that evaluated the effects of CBT-I in breast cancer patients. Another paper was retrieved by screening the reference list of the previously selected papers. The research on PubMed generated 18 papers, three of which did not meet the inclusion criteria. Methods: Empirical articles published in peer-reviewed journals from the earliest reports available until August 2015 were considered. The aim of this review is to examine the best available scientific evidence related to CBT-I and insomnia in patients with breast cancer and to assess the effect of CBT-I on their psychosocial functioning, sleep, quality of life, and mood. There is a growing body of evidence about the efficacy of cognitive behavioral therapy for insomnia (CBT-I) in breast cancer survivors (BCS). Pierantoni Hospital, Forlì, Italyīackground: Insomnia is a common sleep disorder in patients with breast cancer and studies show a higher frequency than in the general population but it appears to be understudied and the treatment seems to be a neglected problem. ![]()
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