Insomnia among cancer caregivers: A proposal for tailored cognitive behavioral therapy Journal Article

Authors: Shaffer, K. M.; Garland, S. N.; Mao, J. J.; Applebaum, A. J.
Article Title: Insomnia among cancer caregivers: A proposal for tailored cognitive behavioral therapy
Abstract: Caregivers are relatives, friends, or partners who have a significant relationship with and provide assistance (i.e., physical, emotional) to a patient with often life-threatening, serious illnesses. Between 40 and 76% of caregivers for people with cancer experience sleep disturbance. This is thought to be due, in part, to the unique responsibilities, stressors, and compensatory behaviors endemic to caregiving that serve as precipitating and perpetuating factors of insomnia. Sleep disturbances are associated with significant alterations in one's mental and physical health. Once chronic, insomnia does not remit naturally. Cognitive-behavioral therapy for insomnia (CBT-I) is well-suited to address the multifaceted contributing factors unique to caregivers' sleep disturbance, yet only one intervention has tested a CBT-I informed intervention among cancer caregivers. Toward the goal of developing effective, tailored treatments for insomnia in caregivers, we address the distinct presentation of insomnia among cancer caregivers and describe key modifications to standard CBT-I that address these specific needs and enhance sensitivity and feasibility, modeled in a demonstrative case vignette. Future research must seek to provide a wide range of effective treatment options for this population, including Internet-based, dyadic, and alternative integrative medicine treatments. Applicability of key modifications for caregivers of patients with other chronic illnesses is discussed. Establishing empirically supported interventions for insomnia among cancer caregivers has the potential to enhance their quality of life and care provided, lead to improved bereavement outcomes, and attenuate the notable mental and physical health disparities present in this vulnerable population. © 2017 American Psychological Association.
Keywords: integrative medicine; sleep initiation and maintenance disorders; family caregiver; cognitive behavioral therapy; cancer
Journal Title: Journal of Psychotherapy Integration
Volume: 28
Issue: 3
ISSN: 1053-0479
Publisher: American Psychological Association  
Date Published: 2018-12-01
Start Page: 275
End Page: 291
Language: English
DOI: 10.1037/int0000105
PROVIDER: scopus
PMCID: PMC6147560
PUBMED: 30245560
Notes: Article -- Export Date: 1 November 2018 -- Source: Scopus
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MSK Authors
  1. Jun J Mao
    61 Mao
  2. Kelly M Shaffer
    18 Shaffer