An in-home, voice-activated cognitive behavioral therapy (CBT) program improves insomnia symptoms among breast cancer survivors, according to a study published online Sept. 24 in JAMA Network Open.

Claire M. Starling, M.P.H., from the MedStar Health Research Institute in Washington, D.C., and colleagues assessed the efficacy of a CBT-informed, voice-activated, internet-delivered program for improving insomnia symptoms among breast cancer survivors. The analysis included 70 breast cancer survivors with insomnia who were randomly assigned (1:1) to a smart speaker with a voice-interactive CBT-insomnia (CBT-I) program or educational control for six weeks.

The researchers found that from baseline to follow-up, Insomnia Severity Index scores changed by a mean of −8.4 points in the intervention group versus −2.6 in the control group. Sleep quality, as assessed by diary data, showed statistically significant improvements in the intervention group versus the control group, as did wake after sleep onset (9.54 minutes), sleep onset latency (8.32 minutes), and sleep efficiency (−0.04 percent). However, there was no improvement in total sleep time.

“Future studies should explore potential for scaling in-home sleep programs and increasing application of artificial intelligence and should compare engagement and noninferiority with other effective CBT-I programs,” the authors write.

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