Sleep Therapies for Cancer-Related Sleep Disorders

No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the effectiveness of different sleep therapies for cancer patients with sleep problems. Participants will try various combinations of treatments, including cognitive behavioral therapy (a type of talk therapy), light therapy (also known as phototherapy), and medications like methylphenidate (a stimulant) and melatonin, to determine which combination best improves sleep and overall quality of life. It is open to cancer patients currently undergoing therapy who struggle with sleep disturbances and have their pain under control.

As a Phase 2 trial, this research measures how well the treatment works in an initial, smaller group of people, offering participants the opportunity to contribute to advancements in sleep therapy for cancer patients.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you can participate if you are on stable doses of certain medications like dexamethasone, mirtazapine, zolpidem, benzodiazepines, and phenothiazines. However, you cannot participate if you are currently taking or have recently taken medications like methylphenidate, certain antidepressants, or anticonvulsants.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that cognitive behavioral therapy (CBT) is safe and well-tolerated by cancer survivors, with most patients experiencing no side effects. Methylphenidate hydrochloride, another component of the trial, is also considered safe. Studies indicate it is generally well-tolerated, with only a few patients discontinuing treatment due to side effects.

Therapeutic melatonin, used in the trial, is generally safe, though information on long-term use is limited. Higher doses have shown no harm in healthy individuals. Phototherapy, or light therapy, is considered safe and easy to use, with few side effects, making it a low-risk option for improving sleep quality.

Overall, these treatments are usually well-tolerated by patients. However, discussing any personal concerns with healthcare providers is important.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for cancer-related sleep disorders because they combine cognitive behavioral therapy (CBT) with other innovative approaches like light therapy, melatonin, and methylphenidate. Unlike standard treatments that might rely solely on medication or simple sleep hygiene practices, this trial explores a multimodal approach. The combination of therapies aims to target sleep issues from multiple angles: CBT helps change negative thought patterns, light therapy can reset the body's internal clock, melatonin regulates the sleep-wake cycle, and methylphenidate could combat fatigue. By integrating these methods, researchers hope to provide a more comprehensive and effective treatment option that addresses various aspects of sleep disorders in cancer patients.

What evidence suggests that this trial's treatments could be effective for cancer-related sleep disorders?

Research has shown that cognitive behavioral therapy (CBT), one of the treatments in this trial, helps address sleep problems in cancer patients. Studies indicate that CBT significantly improves insomnia and reduces tiredness. Melatonin, another treatment option in this trial, is a hormone that regulates sleep and has been found to enhance sleep quality and lessen cancer-related fatigue. Light therapy, also tested in this trial, uses bright light to reset sleep patterns and has proven effective in improving sleep quality and reducing insomnia symptoms in cancer patients. Methylphenidate, another treatment under study, is sometimes used for tiredness but has not consistently outperformed a placebo for cancer-related fatigue. Overall, CBT, melatonin, and light therapy have strong evidence supporting their effectiveness in improving sleep issues in cancer patients.35678

Who Is on the Research Team?

Sriram Yennu | MD Anderson Cancer Center

Sriram Yennu

Principal Investigator

M.D. Anderson Cancer Center

Are You a Good Fit for This Trial?

This trial is for cancer patients experiencing sleep disturbances, on stable pain control, and undergoing cancer therapy. They must have a certain level of physical functioning (Zubrod <= 2), controlled symptoms of pain and depression, normal organ function tests, and not be on excluded medications or have specific conditions like blindness or major psychiatric disorders.

Inclusion Criteria

Your blood creatinine level is less than or equal to 2.0 mg/dL.
I have been on a stable dose of certain medications like dexamethasone or zolpidem for 2 weeks.
My pain and depression, if any, have been stable for the last 2 weeks.
See 7 more

Exclusion Criteria

Unable to speak and understand English
I have fast heartbeats and high blood pressure that my doctor finds concerning.
Unable to complete the baseline assessment forms or to understand the recommendations for participation in the study
See 15 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo cognitive behavioral therapy, receive methylphenidate hydrochloride, therapeutic melatonin, and light therapy or their placebos for 15 days

2 weeks
3 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

2 weeks
2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • Cognitive Behavioral Therapy
  • Methylphenidate Hydrochloride
  • Multimodal Therapy
  • Phototherapy
  • Therapeutic Melatonin
Trial Overview The study is testing whether cognitive behavioral therapy combined with methylphenidate hydrochloride (a stimulant), therapeutic melatonin (a sleep aid), and light therapy can improve sleep quality, reduce fatigue, and enhance overall well-being in cancer patients with sleep issues.
How Is the Trial Designed?
8Treatment groups
Experimental Treatment
Group I: Arm VIII (placebo, melatonin, sham light intervention, CBT)Experimental Treatment5 Interventions
Group II: Arm VII (methylphenidate, placebo, sham light therapy, CBT)Experimental Treatment5 Interventions
Group III: Arm VI (placebo, placebo, light therapy, CBT)Experimental Treatment4 Interventions
Group IV: Arm V (placebo, melatonin, light therapy, CBT)Experimental Treatment5 Interventions
Group V: Arm IV (methylphenidate, placebo, light therapy, CBT)Experimental Treatment5 Interventions
Group VI: Arm III (methylphenidate, melatonin, sham light therapy, CBT)Experimental Treatment5 Interventions
Group VII: Arm II (placebo, placebo, sham light therapy, CBT)Experimental Treatment4 Interventions
Group VIII: Arm I (methylphenidate, melatonin, light therapy, CBT)Experimental Treatment5 Interventions

Cognitive Behavioral Therapy is already approved in European Union, United States, Canada for the following indications:

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Approved in European Union as Cognitive Behavioral Therapy for:
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Approved in United States as Cognitive Behavioral Therapy for:
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Approved in Canada as Cognitive Behavioral Therapy for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

M.D. Anderson Cancer Center

Lead Sponsor

Trials
3,107
Recruited
1,813,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Published Research Related to This Trial

Cognitive Behavioral Therapy for Insomnia (CBT-I) has been shown to significantly improve sleep quality and psychological outcomes in cancer patients and survivors, based on a review of 12 studies.
CBT-I not only enhances sleep but may also positively affect mood, fatigue, and overall quality of life, and it can be delivered through various methods to reach more patients.
Sleeping well with cancer: a systematic review of cognitive behavioral therapy for insomnia in cancer patients.Garland, SN., Johnson, JA., Savard, J., et al.[2022]
Cognitive behavioral therapy (CBT) techniques, such as stimulus control and relaxation, can effectively address sleep issues in cancer patients, who often face unique challenges that worsen their sleep problems.
The article emphasizes the importance of tailoring CBT techniques to individual factors like age, gender, and cancer history to enhance their effectiveness in improving sleep quality for cancer patients.
Cognitive Behavioral Therapy for Sleep in Cancer Patients: Research, Techniques, and Individual Considerations.Melton, L.[2020]

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/38552188/
Randomized Controlled Trial of Virtually Delivered ...This study examined the efficacy and durability of cognitive behavioral therapy for insomnia (CBT-I) on perceived CRCI in cancer survivors.
2.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39826090/
Impact and mechanisms of cognitive behavioral therapy for ...Conclusions: CBT-I resulted in significant improvement in fatigue, and these effects were largely accounted for by changes in insomnia. CBT-I is ...
Improving sleep outcomes in patients with cancer ...Conclusions: Cognitive Behavioral Therapy for Insomnia demonstrates efficacy in the treatment of chronic insomnia in cancer patients and is ...
Web-based cognitive-behavioral therapy for insomnia in ...Our results indicate that, in cancer survivors, web-based CBT-I appears to be effective in reducing insomnia severity and improving daytime functioning and ...
Impact and mechanisms of cognitive behavioral therapy for ...CBT-I resulted in significant improvement in fatigue, and these effects were largely accounted for by changes in insomnia. CBT-I is a robust intervention with ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/40352744/
Recording and reporting of adverse events during a ...CBT-I is a safe treatment that is well-tolerated by cancer survivors. The majority of participants did not experience AEs that could be attributed to the ...
Recording and reporting of adverse events during a ...CBT-I is a safe treatment that is well-tolerated by cancer survivors. The majority of participants did not experience AEs that could be ...
Sleeping well with cancer: a systematic review of cognitive ...This article presents a comprehensive review of the literature examining the efficacy of CBT-I on sleep and psychological outcomes in cancer patients and ...
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