Understanding and Treating Sleep Disturbance in Women Receiving Chemotherapy for Breast Cancer

This thesis aimed to better understand sleep problems in women with breast cancer, and to develop a treatment to improve sleep during chemotherapy. In a 12-month study of 460 women, insomnia and fatigue symptom patterns were identified and women with higher psychological stress were more likely to have worse sleep and fatigue outcomes. To improve these symptoms, we trialled combined cognitive behaviour therapy for insomnia and light therapy (CBT+), in 101 women undergoing chemotherapy. CBT+ led to significant improvements in insomnia and fatigue. These findings are an important step toward incorporating accessible, effective treatment for sleep into routine cancer care.