Evidence map›Paper›PMID 39934523›Full record

Trial reportJournal of cancer survivorship : research and practice2026

The effect of insomnia treatment on work productivity and related costs among cancer survivors with insomnia and comorbid perceived cognitive impairments: A secondary analysis of a randomized controlled trial.

Joshua Tulk, Lynn Gambin, Sondria Browne, Kara Laing, Joshua A Rash, Josée Savard, Melanie Seal, John Thoms, Robin Urquhart, Sheila N Garland

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Journal of cancer survivorship : research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Joshua TulkDepartment of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada.ORCID 0000-0001-9908-263X
Lynn GambinDepartment of Economics, Faculty of Humanities and Social Sciences, Memorial University, St. John's, NL, Canada.ORCID 0000-0002-1283-581X
Sondria BrowneDepartment of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada.
Kara LaingDivision of Oncology, Faculty of Medicine, Memorial University, St. John's, NL, Canada.
Joshua A RashDepartment of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada.ORCID 0000-0003-0927-0712
Josée SavardÉcole de Psychologie, Faculté Des Sciences Sociales, Université Laval, Quebec, QC, Canada.ORCID 0000-0002-8052-1046
Melanie SealDivision of Oncology, Faculty of Medicine, Memorial University, St. John's, NL, Canada.
John ThomsDivision of Oncology, Faculty of Medicine, Memorial University, St. John's, NL, Canada.
Robin UrquhartDepartment of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.ORCID 0000-0001-8864-5716
Sheila N GarlandDepartment of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada. sheila.garland@mun.ca.ORCID 0000-0002-6119-318X

Funding

Canadian Cancer Society 707146CIHR PJT 162428
6 · The paper itself

Abstract

purposeThis secondary analysis of a randomized clinical trial aimed to understand the cost-effectiveness of cognitive behavioral therapy for insomnia (CBT-I) in improving absenteeism (i.e., time away from work) and presenteeism (i.e., unproductivity while at work) among cancer survivors.

methodsA total of 55 currently employed mixed cancer survivors who met DSM-5 criteria for insomnia disorder and self-reported cognitive impairments were randomized to receive seven weekly, individual CBT-I sessions immediately or after a waiting period. Participants completed the Work Productivity and Activity Impairment Questionnaire (WPAI). Information from participants and the Labour Force Survey (LFS) were used to calculate costs. Education-adjusted mixed-effects models using intention-to-treat principles assessed immediate and longer-term effects of treatment on work productivity.

resultsWhile CBT-I was not associated with significant improvements in absenteeism, the treatment group reported a 23.5-point reduction in presenteeism post-treatment, compared to a 0.45-point decrease in the waitlist control group. Improvements in presenteeism were maintained at 6-month follow-up. The mean cost of total work productivity loss was CAD627.59 per person per week before beginning CBT-I. Treatment resulted in a 48.4%, 44.6%, and 30.5% reduction in lost productivity immediately, 3 and 6 months post-treatment, respectively. Total cost savings for the first year after treatment, adjusting for treatment costs, were estimated at CAD 9478.82.

conclusionsIntervening upon late and long-term effects of cancer treatment (e.g., sleep, fatigue, cognitive impairment) through CBT-I produces meaningful and durable improvements in work productivity, particularly presenteeism. IMPLICATIONS FOR CANCER SURVIVORS: With appropriate treatment, survivors can address side effects and increase productivity, but additional work is needed to improve access to and coverage for evidence-based interventions.

Indexed as

Cancer SurvivorsCognitive Behavioral TherapyCognitive DysfunctionNeoplasmsSleep Initiation and Maintenance DisordersAbsenteeismAdultComorbidityCost-Benefit AnalysisEfficiencyFemaleHumansMaleMiddle AgedPresenteeismCancer survivorCognitive behavioral therapyInsomniaProductivityWorkplace

Identifiers

What OpenQuestion holds

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Registered trials

None linked

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.