Sleep Disorder Clinical Trial
Official title:
Feasibility, Acceptability and Mechanisms of Brief Behavioral Therapy (BBT) for Sleep Problems During Chemotherapy: A Phase II Randomized Controlled Trial
This randomized phase II trial studies how well brief behavioral therapy works in improving sleep disorders in patients with stage I-III breast cancer undergoing chemotherapy. Sleep disorder counseling may reduce fatigue and insomnia as well as improve the well-being and quality of life in patients with breast cancer who are undergoing chemotherapy.
PRIMARY OBJECTIVES:
I. Determine recruitment rates to the proposed randomized controlled trial (RCT).
II. Determine the rate of intervention adherence. III. Determine the feasibility of training
National Cancer Institute (NCI) Community Oncology Research Program (NCORP) clinical research
staff to successfully deliver the Brief Behavioral Therapy (BBT) intervention.
SECONDARY OBJECTIVES:
I. Obtain preliminary estimates for the effect of the intervention (compared with control) on
insomnia as measured by the Insomnia Severity Index (ISI).
II. Obtain preliminary estimates for the effect of the intervention (compared with control)
on sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI).
III. Obtain preliminary estimates for the effect of the intervention (compared with control)
on circadian rhythm as measured by the two-oscillator cosinor parameter estimates based on
actigraphy data.
IV. Obtain preliminary estimates for the effect of the intervention (compared with control)
on heart rate variability (HRV) as measured by the Firstbeat® ambulatory heart-rate monitor
(i.e., 1. respiratory sinus arrhythmia-RSA, 2. standard deviation of all normal R-wave to
R-wave intervals--SDNN, 3. root mean square of successive differences between adjacent normal
R-wave to R-wave intervals--RMSSD, 4. The ratio of low frequency total spectrum power of all
NN intervals between .04 to .15 Hertz to high frequency total spectrum power of all NN
intervals between .15 to .40 Hertz--LF/HF ratio, and 5. natural log of low frequency total
spectrum power of all NN intervals between 0.04 to 0.15Hz.).
TERTIARY OBJECTIVES:
I. Obtain preliminary estimates for the effect of the intervention (compared with control) on
quality of life as measured by the Functional Assessment of Chronic Illness Therapy (FACIT)
total score and subscales.
II. Obtain preliminary estimates for the effect of the intervention (compared with control)
on general mood as measured by the Profile of Mood States (POMS) total score and subscales.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients undergo BBT intervention, comprising insomnia education, stimulus control,
discouragement of napping and encouragement of exercise, and sleep compression over two 60
minute face-to-face sessions in weeks 1 and 3 or 4, and four 15 minute telephone sessions in
weeks 2, 3, 5, and 6 or 2, 4, 5, and 6.
ARM II: Patients undergo Healthy Eating Education (HEAL) comprising nutritional education and
suggestions for symptom management over two 60 minute face-to-face sessions in weeks 1 and 2
or 3, and four 15 minute telephone sessions in weeks 2, 3, 5, and 6 or 2, 4, 5, and 6.
After completion of study, patients are followed up at 1 month.
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