Acupuncture versus cognitive behavioral therapy for anxiety among cancer survivors with insomnia: An exploratory analysis of a randomized clinical trial Journal Article
| Authors: | Kwag, E.; Li, X.; Garland, S.; Bryl, K.; Taylor, L.; Li, Q. S.; Amann, L.; Mao, J. J.; McConnell, K. M. |
| Article Title: | Acupuncture versus cognitive behavioral therapy for anxiety among cancer survivors with insomnia: An exploratory analysis of a randomized clinical trial |
| Abstract: | Background: Anxiety and insomnia frequently co-occur among cancer survivors and are strongly interconnected, yet no widely accepted intervention simultaneously targets both symptoms. Methods: Data were drawn from a dual-center, parallel-group, randomized, comparative effectiveness trial evaluating acupuncture versus CBT-I for insomnia. Seventy-six participants with baseline Hospital Anxiety and Depression Scale-Anxiety (HADS-A) scores of ≥8 were included. Both interventions were administered over eight weeks, with follow-up until 20 weeks. Anxiety was assessed at baseline, week 8, and week 20 using HADS-A. A linear mixed-effects model was used to examine mean change in HADS-A scores. Additionally, responder analyses were conducted, with insomnia and anxiety responders defined as patients demonstrating clinically meaningful improvements in either outcome by week 8. Results: Both CBT-I and acupuncture significantly reduced HADS-A scores at week 8 (CBT-I: -3.75; acupuncture: -3.14) and week 20 (CBT-I: -3.05; acupuncture: -2.66) compared to baseline (all p < 0.001). There was no between-group difference (p=0.85). In responder analyses, CBT-I showed greater anxiety reduction in insomnia responders (-4.62) than non-responders (-0.45), at both time points (week 8: p=0.0046; week 20: p=0.038). In the acupuncture group, the difference in anxiety reduction between insomnia responders (-3.96) and non-responders (-1.58) was not statistically significant. Conclusion: Both acupuncture and CBT-I effectively manage comorbid anxiety and insomnia in cancer survivors. Acupuncture may address these symptoms independently, while CBT-I may improve them in an interconnected manner. Trial registration: ClinicalTrials.gov registration (NCT02356575). © 2025 Elsevier B.V., All rights reserved. |
| Keywords: | adult; controlled study; treatment response; major clinical study; clinical feature; treatment duration; follow up; cancer diagnosis; breast cancer; psychology; cancer survivor; prostate cancer; insomnia; hematologic malignancy; colon cancer; comorbidity; anxiety disorder; acupuncture; anxiety; rectum cancer; caucasian; student; hispanic; secondary analysis; cancer survivors; randomized controlled trial (topic); female genital tract cancer; comparative effectiveness; exploratory research; neck cancer; college; head cancer; high school; human; male; female; article; psychotherapist; likert scale; insomnia severity index; cbt-i; cognitive behavioral therapy for insomnia; hospital anxiety and depression scale-anxiety |
| Journal Title: | Integrative Medicine Research |
| Volume: | 14 |
| Issue: | 4 |
| ISSN: | 2213-4220 |
| Publisher: | Elsevier BV |
| Date Published: | 2025-12-01 |
| Start Page: | 101213 |
| Language: | English |
| DOI: | 10.1016/j.imr.2025.101213 |
| PROVIDER: | scopus |
| PMCID: | PMC12395375 |
| PUBMED: | 40896348 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK author is Kelly M. McConnell -- Source: Scopus |
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