A comprehensive Cochrane review of 21 randomized controlled trials involving 2431 participants evaluated the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) in people with cancer. The findings suggest that CBT-I may provide small improvements in patient-reported insomnia severity and sleep quality compared with inactive control interventions, although the overall certainty of evidence was low to very low. Improvements in subjective sleep diary outcomes such as sleep onset latency and wake after sleep onset were also noted, while serious adverse events appeared similar between intervention and control groups.
When compared with aerobic activity interventions, CBT-I may similarly improve insomnia severity and sleep quality, but benefits across objective sleep measures remained minimal or inconsistent. Evidence for improvements in parameters such as total sleep time and sleep efficiency was weak or uncertain across both subjective and objective assessments. Overall, the review emphasizes the need for more rigorous, long-term trials to fully understand the clinical value of CBT-I in cancer-related insomnia.