Snoozing science seeks to find out how therapy boosts sleep in breast cancer survivors

A new study at Memorial University is looking into the connection between breast cancer survivors and insomnia by measuring brain waves during sleep.

Dr. Sheila Garland, associate professor of psychology and oncology and a registered clinical psychologist at Memorial University, is collecting data that demonstrates how cognitive behavioural therapy for insomnia (CBT-I) improves sleep.

As opposed to using drugs to treat insomnia, CBT-I targets the thoughts, behaviours and emotions that can make it hard for people to sleep.

"We will be able to learn more about how this treatment actually changes the sleeping brain," Garland told CBC News.

The study uses a Cerebra device worn on the face to measure brain waves. Garland said the device allows people to be in their beds instead of having to come into a lab to take readings.

Breast cancer patients can experience insomnia for a number of reasons, she said, in part because most people who are diagnosed are also experiencing mid-life hormonal changes, as well as the impact that stress and cancer treatment can have on sleep.

Garland is looking to recruit a total of 24 women who live in the St. John's area and who have completed breast cancer treatment to register for the study.

Potential participants answer a questionnaire about their moods, sleep, cognition and fatigue. From there, successful applicants undergo performance tests for memory, concentration and emotional functions.

Then they are given a Cerebra device to take home and wear overnight, which is returned the next day, said Garland.

That's followed by seven cognitive behavioural therapy sessions over several weeks, and then participants wear the cerebra for another night to see if there were any changes in sleep.

Sleep boosted

Dana Warren, a breast cancer survivor who had insomnia, heard about the study over social media and registered. 

Living with insomnia impacted her quality of life, she said, and she found herself cancelling plans and frequently worried if she'd be able to sleep.

"It's kind of this negative cloud that shows up and, you know, takes away quite a lot of things that help us feel connected, and healthy and engaged and that's the kind of stuff you need to get back to yourself," said Warren.

However, since participating in weeks of therapy through Garland's study, she said she's experienced a marked improvement over her ability to sleep, calling it a "game-changer."

"I am not waking up in the night five or six times anymore. I'm not staying awake for two hours anymore," Warren said. "If I wake up, I fall back to sleep."

Before the study, Warren would begin to wind down her day at 9:30 p.m., which she thought was a good sleep habit. Now, she said, she can go to bed at 11 p.m. and wake up at 6 a.m.

Her quality of sleep has dramatically improved, she said, and now she has the energy to go out at night.

Building on existing research

There is existing research on how sleep improves after CBT-I, but Garland hopes to expand on that to understand why and how it works, which will also add to subjective self-reporting accounts from women on how the therapy improves their sleep.

"I want to understand how is it that this treatment actually deepens your sleep and that increased sleep depth is related to better memory functioning, better attention, better emotional processing," said Garland.

"I want to get at the mechanisms of how it works. So we know it works, but we don't know how. And that's why I think that the only way that we're going to get that is really by, you know, sort of looking at the sleeping brain."

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