A recent randomized clinical trial has found that women undergoing chemotherapy for breast cancer experienced significant improvements in insomnia symptoms when using cognitive behavior therapy for insomnia (CBT-I). The study, part of the Sleep, Cancer, Rest trial, was conducted over six weeks across five hospitals in Australia from January 2021 to August 2024, involving 219 women aged 18 and older with early or metastatic breast cancer.

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Participants were divided into groups receiving CBT-I, bright light therapy (BLT), both interventions, or sleep hygiene education, with all groups receiving the latter. Each intervention provided a consultation, regular email check-ins, and a midpoint telephone call, while those receiving BLT utilized special glasses delivering 1500 lux.

Out of the participants, 208 women were included for analysis regarding insomnia and fatigue measures. The results indicated that insomnia symptoms improved significantly more among those receiving CBT-I, showing a mean difference of -2.19 points on the Insomnia Severity Index (ISI) compared to the non-CBT-I group (95% CI: -3.33 to -1.05; P=0.002). However, there was no significant difference in fatigue levels between the CBT-I and non-CBT-I groups, with a mean difference of -0.90 points on the Patient-Reported Outcomes Measurement Information System Fatigue score (95% CI: -3.08 to 1.28; P=0.52).

In contrast, bright light therapy did not demonstrate a meaningful impact on either insomnia or fatigue compared to the control group. The insomnia mean difference was -0.88 points (95% CI: -2.02 to 0.26; P=0.26), and for fatigue, it was -0.71 points (95% CI: -2.89 to 1.47; P=0.52).

Exploratory analyses showed distinct results for women with metastatic breast cancer, where BLT was linked to greater improvements in both insomnia and fatigue compared to those not receiving it. The mean difference for insomnia in this subgroup was -2.87 points (95% CI: -5.06 to -0.67; P=0.01), and for fatigue, it was -5.16 points (95% CI: -9.57 to -0.76; P=0.02).

The researchers concluded that brief CBT-I is effective in reducing insomnia symptoms among women receiving chemotherapy for breast cancer, while BLT does not offer additional benefits for insomnia or fatigue overall. They suggested that the positive findings in the metastatic breast cancer subgroup merit further investigation.