0827 Effect of virtual cognitive behavioral therapy for insomnia on perceived cognitive functioning among cancer survivors

Abstract Introduction Comorbid insomnia and perceived cognitive impairments (PCI) affect up to 26% of individuals diagnosed with cancer. Given the association between sleep and cognition, and the lack of interventions to improve PCI, the present study examined the impact of cognitive behavioral therapy for insomnia (CBT-I) on PCI among cancer survivors with insomnia disorder and cognitive complaints (clinicaltrials.gov:NCT04026048). Methods Cancer survivors (N=122) with insomnia and PCI were randomized to 7 weekly virtual CBT-I treatment sessions (n=56) or waitlist control (WLC: n=66). Participants completed the Insomnia Severity Index and the Functional Assessment of Cancer Therapy – Cognitive Function upon entering the study (baseline; T0), and then again at 4 (T1), and 8 (T2) weeks. A series of 2 (treatment group: CBT-I and WLC) by 3 (time: T0, T1, T2) mixed ANOVAs were performed to assess changes in insomnia symptoms, PCI, perceived cognitive abilities (PCA), and impact of cognitive function on quality of life (QOL). Results Participants were, on average, aged 60 years, had 16 years of education, and 79% were female. Breast cancer was the most reported cancer type (46%). No significant differences were observed between groups at T0 for demographic or clinical variables (p>.05). There was a significant group by time interaction for insomnia [p=<.001, partial eta squared (pes)=.36]. Individuals randomized to CBT-I reported significant decreases in insomnia symptoms post treatment compared to WLC (CBT-I: -11.5; WLC: -2.7). Significant interactions were also observed for PCI (p=<.001, pes=.11), PCA (p=<.001, pes=.16), and impact on QOL (p=<.001, pes=.15). Participants randomized to CBT-I reported significantly less PCI (CBT-I: 14.7; WLC: 4.1), better PCA (CBT-I: 5.8; WLC: 1.1), and less impact on QOL (CBT-I: 4.9; WLC: 1.1) than participants in the WLC. Conclusion In addition to improving insomnia, CBT-I significantly improve perceived cognitive functioning and quality of life among cancer survivors. Further research is needed to understand the mechanisms underlying improvements in cognition following CBT-I. Support (if any) Dr. Sheila Garland is supported by a Canadian Cancer Society Emerging Scholar Award (Survivorship) (grant #707146). This project was funded through a grant from the Canadian Institutes of Health Research (CIHR) (grant number: PJT 162428) and the Beatrice Hunter Cancer Research Institute.