Overview of guideline recommendations for insomnia in oncology: a wake-up call for screening and treatment

Background: Many patients suffer from insomnia symptoms during cancer treatment. Not only is there a high risk that insomnia will persist even after treatment has ended, but it is also associated with the development of other mental and physical illnesses. However, international studies have shown that insomnia in oncology often remains untreated. Objective: This article examines procedures for screening and treatment of insomnia in cancer patients and how they are applied. In addition, ideas are presented on how the treatment of insomnia could be improved. Materials and methods: A narrative review of original research and international guidelines on the diagnosis, screening, and treatment of insomnia in cancer patients was conducted. Results: Frequently used and validated screening instruments are the Insomnia Severity Index with seven items and the Pittsburgh Sleep Quality Inventory with 19 items. If insomnia is suspected, a thorough anamnesis should be carried out that specifies the type of sleep disorder and differentiates it from other disorders. Based on the current evidence, international guidelines for the treatment of insomnia, including in cancer patients, recommend cognitive behavioral therapy for insomnia (CBT-I) as a first-line treatment. New evidence-based developments, such as stepped care interventions or the integration of online-based elements as part of CBT-I, have the potential to increase the available treatment options. Conclusion: Time-saving screening instruments for insomnia are available as well as CBT-I, an effective intervention to improve sleep. Future research should investigate to what extent cancer patients in Germany are screened and treated for insomnia and, potentially, explore ways for them to easily access effective sleep interventions.