Moderators of Treatment Effects of a Video-Based Cognitive-Behavioral Therapy for Insomnia Comorbid With Cancer

Purpose. To assess the moderating role of demographic and clinical variables on the efficacy of a video-based cognitive behavioral therapy for insomnia (VCBT-I) among breast cancer patients. Patients and methods. As part of a randomized controlled trial, 80 women received VCBT-I. Results. Patients with a more advanced breast cancer were less likely to show reductions on the Insomnia Severity Index (ISI) and increased sleep efficiency at posttreatment. Patients using an antidepressant medication showed a larger reduction of ISI scores and a higher rate of insomnia remission. Remission of insomnia was also significantly more likely in individuals with a higher annual income. When using a multivariate binary classification tree analysis, the best and unique predictor of insomnia remission was having a less severe baseline ISI score. Conclusion. Although efficacious in general, VCBT-I does not appear to be an optimal format for everybody.