![]() In this model, insomnia develops and is maintained through predisposing, precipitating, and perpetuating factors. The increased risk of insomnia in adolescents, age-group defined as 12–25 years old, and young adults, age-group 19–30 years old, who had childhood cancer might be explained within the conceptual model of insomnia: the three-factor (3P-) model. Adolescents and young adults who had childhood cancer may even be at increased risk for insomnia, being critically ill during a phase of life that is important in the development of good sleep habits. Furthermore, insomnia developed during childhood tends to become chronic, with up to 88% of adolescents with current insomnia, having a history of insomnia. An additional insomnia diagnosis might therefore pose a double health burden. Childhood cancer survivors are already at increased risk of adverse health outcomes. In the long run, chronic insomnia is related to increased risk of adverse health outcomes, e.g., musculoskeletal pain, other mental disorders, and cardiovascular disease. Insomnia is associated with a lower health-related quality of life (HR-QoL), more fatigue, and worsened psychosocial and neurocognitive functioning. Insomnia is characterized by difficulty in initiating or maintaining sleep for more than 3 nights a week for more than 3 months which significantly impacts daily life functioning. One particular type of sleep problem which is among the most prevalent ones is insomnia. Sleep problems are common after childhood cancer with up to a third reporting significant sleeping disturbance. NL7220 (NTR7419 Netherlands Trial register). If guided iCBT-I is effective, guidelines for insomnia can be installed to treat insomnia and potentially improve quality of life and the health of adolescents and young adults who had childhood cancer. Insomnia is prevalent in the pediatric oncology population posing a double health burden for adolescents and young adults who had childhood cancer. Outcomes include sleep efficiency (actigraphic), insomnia severity (self-report), sleep and circadian activity rhythm parameters, fatigue, health-related quality of life, perceived cognitive functioning, chronic distress, depressive and anxiety symptoms, and intervention acceptability. Adolescents and young adults aged 12–30 years with insomnia, diagnosed with (childhood) cancer, currently at least 6 months since their last cancer treatment will be eligible. The intervention group will be also assessed at 12 months to see whether the post-test effects are maintained. ![]() ![]() Our aim is to evaluate its effectiveness in a national randomized-controlled clinical trial comparing iCBT-I to a waiting-list control condition at 3 and 6 months ( n = 70). i-Sleep is shown effective in adult (breast cancer) patients, but it is unknown if iCBT-I is effective in pediatric oncology. The guided online CBT-I treatment “i-Sleep” has been developed to facilitate access via online care. ![]() However, access to this type of care is often limited. The first-line treatment for insomnia is cognitive behavioral therapy for insomnia (CBT-I). Insomnia and a history of childhood cancer both increase the risk of adverse health outcomes, posing a double burden for adolescents who had childhood cancer. Insomnia is disabling and prevalent after childhood cancer (26–29%) and negatively impacts quality of life, fatigue, pain, and general functioning and is often associated with other (mental) health problems. Adolescents and young adults who had childhood cancer are at increased risk for insomnia, due to being critically ill during an important phase of their life for the development of good sleep habits.
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