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How to Better Manage Insomnia in French Cancer Patients With a Guided Internet-Based Cognitive Behavioral Therapy?
Diane Boinon1,2, Arnaud Pagès3,4, Louise Zanni1,2
1Department for the Organization of Patient Pathways (DIOPP), Gustave Roussy, Villejuif, France.
Cancer Medicine
|April 27, 2026
Summary
Internet-Based Cognitive Behavioral Therapy for Insomnia (ICBT-I) combined with phone guidance improved adherence and remission rates in cancer patients. However, patient characteristics influenced treatment outcomes, suggesting personalized approaches are needed.
Area of Science:
- Oncology
- Sleep Medicine
- Digital Health
Background:
- Internet-Based Cognitive Behavioral Therapy for Insomnia (ICBT-I) offers accessible CBT for cancer patients.
- Low adherence (50%-60%) is a challenge for self-guided ICBT-I.
- The Sleep-4-All-2.0 study integrated ICBT-I (Insomnet) with psychologist-led phone support.
Purpose of the Study:
- To assess the adherence and insomnia remission rates of combined ICBT-I and phone guidance.
- To identify patient characteristics associated with treatment outcomes.
- To evaluate the effectiveness of a blended ICBT-I approach in an oncology setting.
Main Methods:
- A real-world, multicenter, single-arm interventional study.
- Inclusion criteria: any tumor type, Insomnia Severity Index (ISI) score ≥ 8.
- Data collected via online questionnaires at weeks 6, 12, and 24; descriptive and multivariate analyses performed.
Main Results:
- 89% of patients initiated the program; adherence was 74% by week 12.
- Insomnia remission rates reached 50% by week 24.
- Factors like unemployment, sleep medication use, high sleepiness/fatigue, and lower digital skills were associated with poorer outcomes.
Conclusions:
- ICBT-I with phone-based guidance demonstrates good adherence and insomnia remission rates in cancer patients.
- Patient profiling is crucial for optimizing the implementation of ICBT-I programs.
- Personalized interventions may enhance the effectiveness of digital mental health solutions in oncology.
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