STUDY OBJECTIVE: To assess the short-term efficacy of a video-based cognitive 
behavioral therapy for insomnia (CBT-I) as compared to a professionally 
administered CBT-I and to a no-treatment group.
DESIGN: Randomized controlled trial.
SETTING: Radio-oncology department of a public hospital affiliated with 
Université Laval (CHU de Québec).
PARTICIPANTS: Two hundred forty-two women with breast cancer who had received 
radiation therapy in the past 18 mo and who had insomnia symptoms or were using 
hypnotic medications were randomized to: (1) professionally administered CBT-I 
(PCBT-I; n = 81); (2) video-based CBT-I (VCBT-I; n = 80); and (3) no treatment 
(CTL; n = 81).
INTERVENTIONS: PCBT-I composed of six weekly, individual sessions of 
approximately 50 min; VCBT-I composed of a 60-min animated video + six booklets.
MEASUREMENT AND RESULTS: Insomnia Severity Index (ISI) total score and sleep 
parameters derived from a daily sleep diary and actigraphy, collected at 
pretreatment and posttreatment. PCBT-I and VCBT-I were associated with 
significantly greater sleep improvements, assessed subjectively, as compared to 
CTL. However, relative to VCBT-I, PCBT-I was associated with significantly 
greater improvements of insomnia severity, early morning awakenings, depression, 
fatigue, and dysfunctional beliefs about sleep. The remission rates of insomnia 
(ISI < 8) were significantly greater in PCBT-I as compared to VCBT-I (71.3% 
versus 44.3%, P < 0.005).
CONCLUSIONS: A self-administered cognitive behavioral therapy for insomnia 
(CBT-I) using a video format appears to be a valuable treatment option, but 
face-to-face sessions remain the optimal format for administering CBT-I 
efficaciously in patients with breast cancer. Self-help interventions for 
insomnia may constitute an appropriate entry level as part of a stepped care 
model.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00674830.
CITATION: Savard J, Ivers H, Savard MH, Morin CM. Is a video-based cognitive 
behavioral therapy for insomnia as efficacious as a professionally administered 
treatment in breast cancer? Results of a randomized controlled trial.