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Practice Guideline
. 2023 Dec;8(6):102047.
doi: 10.1016/j.esmoop.2023.102047. Epub 2023 Nov 21.

Insomnia in adult patients with cancer: ESMO Clinical Practice Guideline

L Grassi  1 , R Zachariae  2 , R Caruso  1 , L Palagini  3 , R Campos-Ródenas  4 , M B Riba  5 , M Lloyd-Williams  6 , D Kissane  7 , G Rodin  8 , D McFarland  9 , C I Ripamonti  10 , D Santini  11 ; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org
Affiliations
Practice Guideline

Insomnia in adult patients with cancer: ESMO Clinical Practice Guideline

L Grassi et al. ESMO Open. 2023 Dec.

Abstract

  1. •

    Insomnia is common in patients with cancer, with a higher prevalence than observed in the general population.

  2. •

    Insomnia is often under-recognised and inadequately treated in patients with cancer.

  3. •

    Brief validated screening tools are available for the evaluation of insomnia in clinical practice.

  4. •

    First-line therapy should be based on international guidelines recommending cognitive behavioural therapy for insomnia.

Keywords: cancer; insomnia; oncology; psychiatry; psycho-oncology.

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Conflict of interest statement

LG reports personal fees as an advisory board member for Angelini and Fidia, as an invited speaker for Eisai and Med Point and as a consultant for the Istituto a Carattere Scientifico IRCSIRST Meldola (FC); royalties from Minerva Medica, Oxford University Press, Springer and Wiley; nonremunerated roles as a member of the board of directors of the World Psychiatric Association (WPA), chair of the WPA Section on Psycho-Oncology and Palliative Care and co-chair of the WPA section on Psychiatry, Medicine and Primary Care. RZ reports personal fees as an advisory board member for Janssen and an invited speaker for Eli Lilly, MSD, Novo Nordisk and Pfizer; stocks/shares in Novo Nordisk and an institutional research grant from LEO Pharma. MBR reports personal fees for writing engagements and royalties from American Psychiatric Publishing, Inc., Cambridge University Press, Springer and Wiley; nonremunerated roles as co-chair of the WPA Section on Psycho-Oncology and Palliative Care, chair of the National Comprehensive Cancer Network (NCCN) distress guidelines and member of the NCCN fatigue guidelines. MLW reports nonremunerated roles as a member of the research grants panel for Marie Curie Cancer Care, co-chair of the Living With and Beyond Cancer group of the National Cancer Research Institute and chair of the PhD awards committee of Tenovus Cancer Charity. DK reports personal fees as a consultant for Reset Pharmaceutical and royalties from Oxford University Press and Routledge; institutional fees as an invited speaker for Nippo Pharmaceutical. CIR reports personal fees as an invited speaker from Angelini, Kyowa Kirin, Molteni and Mundipharma. RC, LP, RC-R, GR, DM and DS have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Proposed algorithm for screening of insomnia in patients with cancer and cancer survivors. Purple: general categories or stratification; white: other aspects of management. ISI, Insomnia Severity Index; NCCN, National Comprehensive Cancer Network; PCL, Problem Check List.
Figure 2
Figure 2
Proposed algorithm for the management of insomnia in patients with cancer and cancer survivors. Purple: general categories or stratification; white: other aspects of management; turquoise: systemic therapy. BBT-I, brief behavioural therapy for insomnia; CBT-I, cognitive behavioural therapy for insomnia; eCBT-I, digitally delivered cognitive behavioural therapy for insomnia; ISI, Insomnia Severity Index; MBT, mindfulness-based therapy.
See this image and copyright information in PMC

References

    1. Al Maqbali M., Al Sinani M., Alsayed A., et al. Prevalence of sleep disturbance in patients with cancer: a systematic review and meta-analysis. Clin Nurs Res. 2022;31(6):1107–1123. - PMC - PubMed
    1. World Health Organization International Classification of Diseases 11th revision. https://icd.who.int/en Available at. Published 2019.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition- Text Revision (DSM-5-TR). 5th ed. Washington, DC: American Psychiatric Association Publishing; 2022.
    1. American Academy of Sleep Medicine . 3rd ed. American Academy of Sleep Medicine; Darien, IL: 2014. International Classification of Sleep Disorders.
    1. Büttner-Teleagă A., Kim Y.T., Osel T., et al. Sleep disorders in cancer-a systematic review. Int J Environ Res Public Health. 2021;18(21) - PMC - PubMed

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