Trial reportCancer2020
Developing efficient and effective behavioral treatment for insomnia in cancer survivors: Results of a stepped care trial.
Trial report in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Stepped-care models for cancer symptom management: a systematic review of efficacy and cost-effectiveness.Journal of the National Cancer Institute · 2026Pooled it
- Efficacy of cognitive behavioral therapy for insomnia in breast cancer: A meta-analysis.Sleep medicine reviews · 2021Pooled it
- Trial
- Efficacy of a Stepped-Care Approach to Cognitive-Behavioural Therapy for Insomnia (Can-Sleep) in Adolescents and Young Adults With Cancer.Psycho-oncology · 2026Article
- A stepped-care strategy for cognitive behavioral therapy for insomnia in chronic spinal pain-protocol of a randomized clinical trial (the StepUp study).Sleep advances : a journal of the Sleep Research Society · 2026Article
- Sleep health and quality of life in the Detroit Research on Cancer Survivors cohort.Journal of cancer survivorship : research and practice · 2025Article
- Application of stepped care model in cancer patients: a scoping review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Sleep Treatment Education Program for Cancer Survivors: Protocol for an Efficacy Trial.JMIR research protocols · 2024Article
- Dyadic sleep intervention for adult patients with cancer and their sleep-partner caregivers: A feasibility study.Palliative & supportive care · 2024Article
- Personalized Multimodal Lifestyle Intervention as the Best-Evidenced Treatment for Chronic Pain: State-of-the-Art Clinical Perspective.Journal of clinical medicine · 2024Review
- Sleep Treatment Education Program for Young Adult Cancer Survivors (STEP-YA): Protocol for an Efficacy Trial.JMIR research protocols · 2023Article
- Article
- Winner of the Ronald Melzack-Canadian journal of pain = Revue canadienne de la douleur · 2023Article
- Validation of the Three-Item Insomnia Severity Index Short Form in Young Adult Cancer Survivors: Comparison with a Structured Diagnostic Interview.Journal of adolescent and young adult oncology · 2022Article
- Study protocol for the evaluation of Fear-Less: a stepped-care program for fear of cancer recurrence in survivors with early-stage disease.Pilot and feasibility studies · 2022Article
- Article
- AYA 'Can-Sleep' programme: protocol for a stepped-care, cognitive behavioural therapy-based approach to the management of sleep difficulties in adolescents and young adults with cancer.Pilot and feasibility studies · 2022Article
- Long-term patient-reported neurocognitive outcomes in adult survivors of hematopoietic cell transplant.Blood advances · 2022Article
- A population-based psychometric analysis of the insomnia severity index in black women with and without a history of cancer.Journal of sleep research · 2022Article
- The association between sleep problems and general quality of life in cancer patients and in the general population.Frontiers in psychology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundInsomnia is common among cancer survivors. Although behavioral treatments for insomnia are effective, access is limited. Stepped care delivery models may provide insomnia treatment that is more efficient and accessible to cancer survivors.
methodsFifty-one survivors (mean age, 55 years) with elevated Insomnia Severity Index (ISI) scores (≥12) first participated in Sleep Training Education Program (STEP)-1: a single, sleep education session. Those reporting elevated ISI scores 1 month later were offered STEP-2: a 3-session, group cognitive behavioral treatment for insomnia that has been demonstrated to be efficacious. Participants were considered treatment responders if their ISI score improved by ≥6 points and were considered as having remitted if their posttreatment ISI score was <12. Mood was assessed with the Profile of Mood States-Short Form (POMS-SF).
resultsFollowing STEP-1, ISI scores improved (17.1 to 11.2; P < .001), with 45% responding and 41% remitted. Insomnia remission after STEP-1 was associated with lower insomnia severity and shorter duration of sleep problems at baseline. Of the 30 (59%) survivors with unremitted insomnia after STEP-1, 14 (47%) participated in STEP-2. Following STEP-2, ISI scores improved (16.9 to 8.8; P < .001), with 79% responding and 71% remitted. STEP-2 participation was associated with interest in sleep treatment at baseline, but not demographic/health-related variables. Mood improved significantly following both STEP-1 and STEP-2 (P < .001).
conclusionA stepped care approach to treating insomnia among cancer survivors has the potential to improve treatment accessibility. A sizable proportion of survivors can benefit from 2 different low-intensity approaches that could be delivered by nonsleep specialists. For individuals who require more intensive care, assessing treatment interest can identify those who are likely to engage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.