Browsing by Author "Johnson, Jillian"

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    A Pilot Trial of Light Therapy on Fatigue, Mood, Sleep Quality, and Quality of Life in Individuals with Post-Treatment Cancer-Related Fatigue
    (2013-09-23) Johnson, Jillian; Campbell, Tavis
    Cancer-related fatigue (CRF) is a common and distressing symptom reported by individuals with cancer, with 33% of patients continuing to experience fatigue for months or years following treatment. Despite its prevalence, CRF remains relatively undertreated and poorly understood. Light therapy is an effective treatment for a variety of fatigue disorders. This study evaluated the impact of a one-month light therapy treatment on fatigue, mood, sleep quality, and quality of life (QOL) in post-treatment cancer survivors with CRF. Eight participants were randomized to either bright white light (BWL) or dim red light (DRL) and completed baseline and post-treatment measures. Participants in both the BWL and DRL treatments groups showed reductions in fatigue, and improvements in sleep quality and QOL. Given the small sample size and the time of year the study was conducted, the results should be interpreted with caution.
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    Light Therapy for Post-Treatment Cancer-Related Fatigue: An Investigation of Impact on Psychological Outcomes and Biological Mechanisms
    (2016) Johnson, Jillian; Campbell, Tavis; Carlson, Linda; Caird, Jeff; Millet, Guillaume; Palesh, Oxana
    OBJECTIVE: To investigate the impact of a one-month light therapy intervention on symptoms of fatigue, psychological outcomes, and diurnal cortisol rhythms in cancer survivors with clinical fatigue. METHODS: Adult cancer survivors who met diagnostic criteria for cancer-related fatigue were eligible and randomized to receive either bright white light (BWL) or an active comparator (dim red light; DRL). Participants used the device for 30 minutes upon waking for 4 weeks. Baseline and post-intervention assessments of fatigue, mood disturbance, depression, sleep quality, and quality of life were obtained. Participants also provided four saliva samples per day over a period of 3 days both before and after the intervention. Linear mixed-model (LMM) analysis with random slopes and intercepts were conducted on the primary outcome of fatigue, and generalized estimating equations were employed to investigate the secondary psychological outcomes. Cortisol slopes, total cortisol output (area under the curve), and cortisol output at four sampling times were examined for time, group, and interaction effects using LMM analyses. RESULTS: Eighty-one participants were randomized to either BWL (n=42) or DRL (n=39). The light therapy intervention was acceptable as evidenced by high adherence rates and low dropout (2.5%). Overall, participants in the BWL condition displayed greater improvements in symptoms of fatigue than those in the DRL condition (d=.30). Both groups showed improvements on symptoms of mood disturbance, depression, sleep quality, and quality of life over time. A subsample of participants (n=77) were included in the cortisol analyses. Cortisol slope and total cortisol output were unchanged after the intervention, but an increase in output was observed in both groups at the post-intervention noon sample, as well as decreased output at the post-intervention 5pm sample in the BWL condition. CONCLUSION: Early morning exposure to bright white light resulted in improvements in symptoms of fatigue in cancer survivors with clinical fatigue. These findings, along with those of previous research of light therapy in cancer patients and survivors, support the use of light therapy for cancer-related symptoms. Furthermore, light therapy has the potential to impact the diurnal release of cortisol, though further research into the associations with symptoms of fatigue are required.
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    Sleeping well with cancer: a systematic review of cognitive behavioral therapy for insomnia in cancer patients
    (Dove Medical Press Ltd., 2014-6) Garland, Sheila; Johnson, Jillian; Carlson, Linda E.; Perlis, Michael; Gehrman, Philip; Savard, Josee; Campbell, Tavis
    Individuals with cancer are disproportionately affected by sleep disturbance and insomnia relative to the general population. These problems can be a consequence of the psychological, behavioral, and physical effects of a cancer diagnosis and treatment. Insomnia often persists for years and, when combined with already high levels of cancer-related distress, may place cancer survivors at a higher risk of future physical and mental health problems and poorer quality of life. The recommended first-line treatment for insomnia is cognitive behavioral therapy for insomnia (CBT-I), a non-pharmacological treatment that incorporates cognitive and behavior-change techniques and targets dysfunctional attitudes, beliefs, and habits involving sleep. This article presents a comprehensive review of the literature examining the efficacy of CBT-I on sleep and psychological outcomes in cancer patients and survivors. The search revealed 12 studies (four uncontrolled, eight controlled) that evaluated the effects of CBT-I in cancer patients or survivors. Results suggest that CBT-I is associated with statistically and clinically significant improvements in subjective sleep outcomes in patients with cancer. CBT-I may also improve mood, fatigue, and overall quality of life, and can be successfully delivered through a variety of treatment modalities, making it possible to reach a broader range of patients who may not have access to more traditional programs. Future research in this area should focus on the translation of evidence into clinical practice in order to increase awareness and access to effective insomnia treatment in cancer care.