Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

AYA Can-Sleep: An evidence-based approach to the management of sleep difficulties in young people with cancer. (#100)

Andrew Murnane 1 2 , Emma Vaughan 1 3 , Jeremy Lewin 1 4 , Ilana Berger 1 , Joshua F Wiley 5 , Martha Hickey 6 , Dani Bullen 3 , Michael Jefford 4 7 8 , Jeremy Goldin 9 , Jeremy Stonehouse 9 , Maria Ftanou 3 10 , Kate Thompson 1 10
  1. ONTrac at Peter Mac, Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  2. Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences, Faculty of Health Deakin University, Burwood, VIC, Australia
  3. Psychosocial Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  4. Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  5. School of Psychological Sciences & Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
  6. Women’s Gynaecology Research Centre, Royal Women’s Hospital, Melbourne, Victoria, Australia
  7. Health Services Research & Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  8. Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  9. Respiratory Medicine and Sleep Disorders, Royal Melbourne Hospital, Melbourne, VIC, Australia
  10. University of Melbourne, Melbourne, VIC, Australia

Background:

Sleep difficulties are common among adolescent and young adults (AYA) with cancer. Implementing stepped care interventions can improve access to Cognitive Behaviour Therapy (CBT), the gold standard treatment for insomnia. This study aimed to determine feasibility, acceptability and preliminary efficacy of the first known stepped care program to treat sleep difficulties in AYA.

Methods:

AYA were screened using the Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS). If sleep difficulties were identified on ISI/ESS, AYA were screened and referred as needed to a tertiary sleep service for sleep apnoea and restless leg syndrome. Those with sleep difficulties on ISI/ESS and no sleep apnoea/restless leg were referred to a 5-week, self-management CBT program adapted for AYA (CBT-SM). If ISI/ESS scores remained elevated after CBT-SM, they were stepped up to individual CBT. ISI/ESS changes were analysed using a paired t-test.

Results:

51 AYA were recruited (Mage=21.4 years [16y-25y]; 51% on treatment; 38/51 (75%) reported sleep difficulties). There were 5/38 (13%) referred to the tertiary sleep service and 33/38 (87%) referred into CBT-SM. To date, 28 have completed CBT-SM; 17/28 (61%) had a clinically meaningful drop in ISI scores (change ≥3) and five did not complete scheduled assessments. From pre to post CBT-SM, ISI scores declined 3.6 points (Pre:M=13.5 (4.2); Post:M=9.9 (4.6); p<0.01) and ESS scores declined 1.6 points (Pre:M=7.4 (4.0); Post:M=5.6 (4.4); p=0.02). On assessment post CBT-SM, 17 participants met criteria for individual CBT with eight (16%) opting in with data collection ongoing. For those that completed an evaluation of CBT-SM (n=24), 62% of participants, partially or completely attributed improvements in sleep to CBT-SM.

Conclusion:

High level of sleep difficulties were apparent within the AYA population. Data collected to date suggests that the AYA Can-Sleep Program is associated with clinical meaningful improvements in sleep difficulties for some AYA.