0569 Characteristics of Treatment Responders in a Trial of Brief Behavioral Therapy for Cancer-Related Insomnia
Bibliographic record
Abstract
Abstract Introduction Nearly 80% of cancer patients undergoing treatment experience insomnia symptoms and disrupted sleep. Brief Behavioral Therapy for Cancer-Related Insomnia (BBT-CI) has shown to be efficacious for patients with breast cancer undergoing treatment. Few studies have characterized treatment responders from non-responders in oncology settings, which can help facilitate precision-based medicine. In this secondary analysis of breast cancer patients, we analyzed how baseline characteristics differ between treatment responders and non-responders to BBT-CI. Methods Patients with breast cancer (N=73, 51% stage II, M age=50.7 years) completed measures of insomnia severity (ISI), dysfunctional beliefs about sleep (DBAS), emotion regulation (DERS), fatigue (BFI), chronotype (OWL-Lark), and domains of health-related quality of life (HRQoL; EORTC-30) and 93.2% (Msession=5.82, SD=.78) completed all 6 sessions of BBT-CI. Given lack of consensus in the literature, we defined treatment response as either an 8- or 6-point change on the ISI from baseline to endpoint. Results Scores on the ISI reduced, on average, by 4.76 points. Treatment response rates varied widely based on the definition selected; 27% of participants achieved an 8-point reduction on the ISI, whereas 43% achieved a 6-point reduction. At baseline, both levels of responders were more fatigued and reported worse insomnia and sleep quality, had more eveningness tendencies, more unhelpful beliefs about sleep, and poorer social functioning. An 8-point reduction was uniquely associated with worse dyspnea and self-reported cognitive functioning as measured by EORTC-30 scales, whereas a 6-point reduction was associated with younger age and surgical status. Responders did not differ on other demographic or clinical characteristics (e.g., cancer stage or treatment with chemotherapy, hormone therapy, or radiotherapy). Conclusion Treatment responders to BBT-CI had more severe baseline sleep and fatigue symptoms and poorer self-reported HRQoL. Surgical history was associated with more limited treatment response. While regression to the mean remains possible, it may also be that those with more severe baseline symptomatology are more motivated to engage in BBT-CI, and therefore more likely to benefit. These preliminary findings may support the use of stepped care to match higher-intensity interventions to those who need them most. Support (if any) NCI 5R01CA239714
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".