Insomnia in Cancer Survivors A Precision Behavioral Sleep Medicine Approach

Insomnia is among the most prevailing and distressing iatrogenic complaints reported by cancer survivors. Untreated insomnia negatively impacts survivors' functioning, quality of life and health, and may have implications for cancer progression. Cognitive behavioral therapy is recommended as the first-line treatment for cancer-related insomnia but remains largely unavailable in European oncology care. For cancer survivors, it may be prudent to expand the scope of insomnia treatment. In this paper, we analyze the etiopathogenesis of insomnia among cancer populations and review the latest developments in cognitive behavioral therapeutics for cancer-related insomnia. Pondering upon the distinctive nature and pathophysiology of cancer-related insomnia, we discuss opportunities to optimize insomnia treatment in cancer care. We suggest adapting the content and format delivery of standard cognitive behavioral therapy for insomnia to meet the needs of cancer survivors and surmount resource availability. Digital therapeutics may provide cancer survivors who would otherwise be limited to pharmacologic treatment options with the guideline treatment for insomnia. Internet-delivered cognitive behavioral interventions may be integrated into survivorship care programs within healthcare systems.