Can Behavioral Therapy Relieve Headaches for Breast Cancer Survivors?
Posted: Wednesday, October 13, 2021
Oxana Palesh, PhD, MPH, of Stanford Cancer Institute, Stanford University School of Medicine, Palo Alto, California, and colleagues analyzed the impact of brief behavioral therapy for cancer-related insomnia on relieving the burden of headaches in patients treated for breast cancer. Published in the journal Cancer, these results concluded that even though most of these study patients experienced headaches similar to migraines, sleep behavioral therapy appeared to offer many of them relief.
A total of 139 patients with breast cancer who were receiving chemotherapy and had an Insomnia Severity Index score of 8 or greater (subthreshold, moderate, or severe insomnia) were randomly assigned to undergo either brief behavioral therapy for cancer-related insomnia (n = 73) or healthy eating education learning for healthy sleep (n = 66) control intervention. Both strategies were performed over 6 weeks, with heart rate variability and headache outcomes being measured at baseline, 6 weeks, 6 months, and 12 months after therapy initiation.
More than half of patients (51%) on behavioral therapy and 44% of individuals in the control arm had stage II disease. Participants in both groups exhibited moderately severe levels of insomnia, poor sleep quality, and moderate fatigue.
Individuals who received brief behavioral therapy demonstrated a statistically significant reduction in headache burden after 12 months (P = .02)—that appeared to be sustained without further intervention—whereas patients in the control group experienced an increase in headache burden. Interestingly, both groups were observed to have a reduction in the Insomnia Severity Index. Of note, there was an observed inverse relationship between heart rate variability and headache/insomnia, suggesting there may be some autonomic dysfunction.
Disclosure: The study authors reported no conflicts of interest.