Needs and preferences of cancer survivors in an insomnia treatment smartphone app

Abstract

Background: Insomnia affects cancer survivors at a higher rate than the general population, impacting quality of life and physical health. Cognitive behavioural therapy for insomnia (CBT-I), the first-line recommended treatment for insomnia, is effective when delivered digitally through a smartphone app. However, no digital CBT-I program has been developed that addresses the unique needs of cancer survivors. The objective of this study was to understand the experiences of cancer survivors with regards to insomnia and insomnia treatment, while assessing their needs in an insomnia treatment smartphone app. Methods: Cancer survivors meeting criteria for current or past insomnia responded to a digital questionnaire assessing demographic information, and cancer diagnosis and treatment history. Survivors then participated in one-on-one semi-structured interviews about their experiences with insomnia, smartphone use, and needs in an insomnia treatment app. Interviews were recorded and transcribed, and recurrent themes were identified using a process of thematic analysis. Results: Twenty interviews were analyzed. All participants reported incidence or worsening of insomnia following cancer diagnosis or treatment. Smartphone CBT-I was considered acceptable by cancer survivors. Primary needs identified by cancer survivors for an insomnia treatment app included user friendliness, privacy and data security, and evidential basis. Conclusion: Our results suggest that smartphone CBT-I is acceptable to cancer survivors, holding potential to greatly increase access to evidence-based insomnia treatment.