# Mindfulness Intervention for Sleep Disturbance and Symptom Management in Hematologic Cancer Patients During and After Inpatient Treatment

> **NIH NIH K08** · DUKE UNIVERSITY · 2024 · $173,997

## Abstract

Patients with life-threatening hematologic cancer experience insomnia and fatigue, distress, and pain symptoms
that worsen insomnia during and following hospitalization for high-dose chemotherapy. Despite an urgent need,
there are limited symptom management protocols that comprehensively target the challenging treatment (i.e.,
inpatient, outpatient) and symptom demands faced by hematologic cancer patients. We developed and tested a
6-session, therapist-led, telehealth intervention for hematologic cancer patients following discharge from
inpatient treatment (Nite2Day). Nite2Day teaches mindfulness meditations and behavioral strategies to improve
insomnia and related fatigue, distress, and pain symptoms. Nite2Day demonstrated strong feasibility,
acceptability, and significant improvements to primary (insomnia; d=1.20) and secondary outcomes (fatigue,
distress, mindfulness; ds=.38-.89). Nite2Day does not address the inpatient setting where patients describe
sleep quality as especially poor. This pilot randomized controlled trial will extend Nite2Day to the inpatient setting
(Nite2Day+) and assess its feasibility, acceptability, engagement, and outcome patterns. Hematologic cancer
patients (N=60) reporting insomnia symptoms during hospitalization will be randomized (1:1) to Nite2Day+ or
Usual Care. Nite2Day+ will be delivered via a self-paced mobile app in the hospital and include: 1) mindfulness
meditations promoting acceptance of the challenging inpatient setting; 2) brief videos on sleep education (e.g.,
sleep drive, circadian rhythm) and behavioral strategies to improve inpatient sleep quality (e.g., stimulus control,
daytime activity); and 3) tools to manage inpatient sleep disruptions (e.g., sleep mask, ear plugs). Once
discharged home, patients will transition to the previously tested, 6-session protocol. We hypothesize that: 1)
Nite2Day+ will be feasible (accrual N=60/24 months; <25% attrition; >75% adherence to assessments and
intervention), acceptable (M>3/5 satisfaction with procedures; M>3/4 satisfaction with Nite2Day+), and engaging
(Nite2Day+ app log-in, video/skills practice >2x/week); and 2) Nite2Day+ will improve insomnia symptom severity
(primary outcome) and secondary outcomes (fatigue, distress, pain, pre-sleep arousal, mindfulness, symptom
management self-efficacy) from baseline to hospital discharge and after the 6-session protocol, compared to
Usual Care. Dr. Fisher will receive advanced training and expert mentorship in behavioral sleep and cancer
symptom management and behavioral intervention development for inpatient and outpatient settings, and
randomized trial designs and statistical methods for optimizing behavioral treatment regimens to improve the
transition from inpatient to outpatient settings. This training will help Dr. Fisher pursue a future sequential multiple
assignment randomized trial assessing insomnia and symptom management strategies that are responsive to
challenging treatment (i.e., inpatient, outpatient) ...

## Key facts

- **NIH application ID:** 10982416
- **Project number:** 1K08CA283026-01A1
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Hannah M Fisher
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $173,997
- **Award type:** 1
- **Project period:** 2024-07-09 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10982416

## Citation

> US National Institutes of Health, RePORTER application 10982416, Mindfulness Intervention for Sleep Disturbance and Symptom Management in Hematologic Cancer Patients During and After Inpatient Treatment (1K08CA283026-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10982416. Licensed CC0.

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