A pilot study of a novel sleep scoring system to measure insomnia treatment response in breast cancer survivors

Insomnia is prevalent among breast cancer survivors and Cognitive Behavioural Therapy for Insomnia (CBT-I) is an effective treatment. Research using polysomnography (PSG) to objectively measure sleep outcomes in response to CBT-I is limited. This single-arm study of nine breast cancer survivors examined sleep response to CBT-I using an in-home PSG device. The first objective examined feasibility of using the Cerebra Sleep System, an in-home PSG device, pre- and post-treatment. Recruitment and retention rates were relatively low, but the device was feasible to use. Attitudes towards using the device were mixed; some felt it was fine while others felt it was awkward and may have impacted their sleep. The second objective examined CBT-I sleep outcomes measured with sleep diaries and in-home PSG. Sleep diary measures of sleep onset latency, sleep efficiency, and wake after sleep onset significantly improved. PSG-measured sleep efficiency and wake after sleep onset significantly improved but time spent in sleep stages did not significantly change. Using an in-home PSG device may be feasible with changes to improve recruitment and retention rates and lessen the burden on participants. CBT-I may result in objective improvements in sleep continuity metrics. Future research should consider a largescale study with changes in methodology.