Insomnia and fatigue are common complaints among individuals with cancer that often begin prior to diagnosis and last well into survivorship. Additionally, cancer treatments such as chemotherapy and radiation can cause myriad unwanted side effects including insomnia and cancer-related fatigue (CRF); reported by up to 60% and 90% of patients, respectively. Recent research has shown that CRF and insomnia can have deleterious impacts on quality of life and overall survivorship. Current treatments for insomnia and CRF, such as CBT for Insomnia (CBT-I) and/or pharmacological interventions (e.g., Modafinil for fatigue), are only moderately effective. Specifically, CBT-I has only a modest impact on CRF, where effect sizes are only about half of those reported for insomnia. Current treatments are likely ineffective because they do not target maintaining factors of CRF and insomnia specific to cancer populations, such as health-related anxiety. However, to date, no research has evaluated etiology and maintaining factors for insomnia and fatigue in cancer populations specifically. Thus, to improve treatment outcomes for insomnia and CRF among individuals with cancer, there is an acute need to more deeply understand what factors are precipitating and maintaining insomnia and CRF in this population.

This study evaluates insomnia and cancer-related fatigue (CRF) among patients undergoing radiation therapy (assessed both pre- and post-treatment). Patients receiving treatment in the Penn Radiation & Oncology Clinic were asked to complete questionnaires assessing insomnia and fatigue. Participants were asked about when their insomnia and/or fatigue began (e.g., before cancer onset or upon diagnosis) and other maintaining factors via questionnaire. 

The project has three main aims. First, we will characterize insomnia and CRF prevalence and severity (measured via self-report surveys) across stages of cancer diagnosis, treatment, and recovery. Second, we aim to characterize rates of insomnia and CRF onset reported prior to, during, and after cancer treatment. Third survey responses will be used to examine trajectories of insomnia and CRF specific to cancer populations.

Role: Principal Investigator
Funding: Chair's Research Grant,  University of Pennsylvania Department of Radiation Oncology