"Nurse, I Can't Sleep!": Approaches to Management of Insomnia in Oncology Patients

Dambrosio, Nina Margaret BSN, RN, OCN; Mazanec, Polly PhD, ACNP, AOCN, FPCN

Insomnia frequently presents during cancer therapy in a symptom cluster along with pain, fatigue, and mood disturbance, negatively affecting functional status and quality of life in many patients. Patients often first report their sleep disturbance to nurses. During each clinical contact across all oncology practice settings, nurses should inquire, “Do you experience difficulty sleeping?” and “Do you have difficulty falling asleep and/or staying asleep?” The National Institutes of Health Consensus and the American Academy of Sleep Medicine Practice Parameters recommend Cognitive Behavioral Therapy for Insomnia to be standard treatment based on the high level of empirical support. The most frequently used therapies utilized in oncology clinics include stimulus control therapy, sleep restriction therapy, relaxation therapies, paradoxical intention, and sleep hygiene education. Cognitive Behavioral Therapy for Insomnia has similar efficacy with more sustainability when compared with sleep medicines. When adequately trained with proper assessment skills, nurses can identify contributing factors for sleep disturbance and are in a better position to intervene across all settings of cancer care and improve patient and family caregiver quality of life. 

 
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