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Sleep Initiation and Maintenance Disorders: HELP
Articles by Patricia A. Ganz
Based on 4 articles published since 2008
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Between 2008 and 2019, Patricia A. Ganz wrote the following 4 articles about Sleep Initiation and Maintenance Disorders.
 
+ Citations + Abstracts
1 Review Supportive care after curative treatment for breast cancer (survivorship care): resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement. 2013

Ganz, Patricia A / Yip, Cheng Har / Gralow, Julie R / Distelhorst, Sandra R / Albain, Kathy S / Andersen, Barbara L / Bevilacqua, Jose Luiz B / de Azambuja, Evandro / El Saghir, Nagi S / Kaur, Ranjit / McTiernan, Anne / Partridge, Ann H / Rowland, Julia H / Singh-Carlson, Savitri / Vargo, Mary M / Thompson, Beti / Anderson, Benjamin O. ·University of California, Los Angeles, CA, USA. ·Breast · Pubmed #24007941.

ABSTRACT: Breast cancer survivors may experience long-term treatment complications, must live with the risk of cancer recurrence, and often experience psychosocial complications that require supportive care services. In low- and middle-income settings, supportive care services are frequently limited, and program development for survivorship care and long-term follow-up has not been well addressed. As part of the 5th Breast Health Global Initiative (BHGI) Global Summit, an expert panel identified nine key resources recommended for appropriate survivorship care, and developed resource-stratified recommendations to illustrate how health systems can provide supportive care services for breast cancer survivors after curative treatment, using available resources. Key recommendations include health professional education that focuses on the management of physical and psychosocial long-term treatment complications. Patient education can help survivors transition from a provider-intense cancer treatment program to a post-treatment provider partnership and self-management program, and should include: education on recognizing disease recurrence or metastases; management of treatment-related sequelae, and psychosocial complications; and the importance of maintaining a healthy lifestyle. Increasing community awareness of survivorship issues was also identified as an important part of supportive care programs. Other recommendations include screening and management of psychosocial distress; management of long-term treatment-related complications including lymphedema, fatigue, insomnia, pain, and women's health issues; and monitoring survivors for recurrences or development of second primary malignancies. Where possible, breast cancer survivors should implement healthy lifestyle modifications, including physical activity, and maintain a healthy weight. Health professionals should provide well-documented patient care records that can follow a patient as they transition from active treatment to follow-up care.

2 Article Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial. 2017

Irwin, Michael R / Olmstead, Richard / Carrillo, Carmen / Sadeghi, Nina / Nicassio, Perry / Ganz, Patricia A / Bower, Julienne E. ·All authors: University of California Los Angeles, Los Angeles, CA. ·J Clin Oncol · Pubmed #28489508.

ABSTRACT: Purpose Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer. Patients and Methods This was a randomized, partially blinded, noninferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up). Primary outcome was insomnia treatment response-that is, marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index-at 15 months. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression. Results Of 145 participants who were screened, 90 were randomly assigned (CBT-I: n = 45; TCC: n = 45). The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of noninferiority showed that TCC was noninferior to CBT-I at 15 months ( P = .02) and at months 3 ( P = .02) and 6 ( P < .01). For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms (all P < .01), but not polysomnography, with similar improvements in both groups. Conclusion CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.

3 Article Tai chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia: a randomized controlled trial. 2014

Irwin, Michael R / Olmstead, Richard / Breen, Elizabeth C / Witarama, Tuff / Carrillo, Carmen / Sadeghi, Nina / Arevalo, Jesusa M G / Ma, Jeffrey / Nicassio, Perry / Ganz, Patricia A / Bower, Julienne E / Cole, Steve. ·Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience, Los Angeles, CA (MRI, RO, ECB, TW, CC, NS, JMGA, JM, PN, JEB, SC) · Department of Psychiatry and Biobehavioral Sciences (MRI, RO, ECB, JMGA, JM, PN, JEB, SC), and Department of Medicine (JMGA, PAG, SC), UCLA David Geffen School of Medicine, Los Angeles, CA · Division of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA (PAG) · Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA (MRI, PAG, JEB, SC) · Department of Psychology, UCLA, Los Angeles, CA (MRI, JEB). ·J Natl Cancer Inst Monogr · Pubmed #25749595.

ABSTRACT: BACKGROUND: Mind-body therapies such as Tai Chi are widely used by breast cancer survivors, yet effects on inflammation are not known. This study hypothesized that Tai Chi Chih (TCC) would reduce systemic, cellular, and genomic markers of inflammation as compared with cognitive behavioral therapy for insomnia (CBT-I). METHODS: In this randomized trial for the treatment of insomnia, 90 breast cancer survivors with insomnia were assigned to TCC or CBT-I for 2-hour sessions weekly for 3 months. At baseline and postintervention, blood samples were obtained for measurement of C-reactive protein and toll-like receptor-4-activated monocyte production of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF), with a random subsample (n = 48) analyzed by genome-wide transcriptional profiling. RESULTS: Levels of C-reactive protein did not change in the TCC and CBT-I groups. Levels of toll-like receptor-4-activated monocyte production of IL-6 and TNF combined showed an overall reduction in TCC versus CBT-I (P < .02), with similar effects for IL-6 (P = .07) and TNF (P < .05) alone. For genome-wide transcriptional profiling of circulating peripheral blood mononuclear cells, expression of genes encoding proinflammatory mediators showed an overall reduction in TCC versus CBT-I (P = .001). TELiS promoter-based bioinformatics analyses implicated a reduction of activity of the proinflammatory transcription factor, nuclear factor-κB, in structuring these differences. CONCLUSIONS: Among breast cancer survivors with insomnia, 3 months of TCC reduced cellular inflammatory responses, and reduced expression of genes encoding proinflammatory mediators. Given the link between inflammation and cancer, these findings provide an evidence-based molecular framework to understand the potential salutary effects of TCC on cancer survivorship.

4 Article Cancer-related intrusive thoughts predict behavioral symptoms following breast cancer treatment. 2014

Dupont, Alexandra / Bower, Julienne E / Stanton, Annette L / Ganz, Patricia A. ·Department of Psychology, University of California. · UCLA School of Medicine. ·Health Psychol · Pubmed #23379385.

ABSTRACT: OBJECTIVE: Behavioral symptoms are common in breast cancer survivors, including disturbances in energy, sleep, and mood, though few risk factors for these negative outcomes have been identified. Our study examined intrusive thoughts as a predictor of lingering symptoms in breast cancer survivors in the year following treatment. METHOD: Data come from the Moving Beyond Cancer psychoeducational intervention trial, aimed at easing the transition from patient to survivor. Women (n = 558) completed psychosocial questionnaires within 4 weeks posttreatment and again 2, 6, and 12 months later. We examined intrusive thoughts about cancer at the baseline assessment as a predictor of fatigue, sleep problems, pain, breast cancer-specific symptoms, depressive symptoms, negative affect, and quality of life using growth curve modeling, controlling for study condition and other covariates. RESULTS: Intrusive thoughts were associated with higher levels of all symptoms at baseline and at the 12-month assessment. Intrusive thoughts also influenced the trajectory of pain, depressive symptoms, negative affect, and physical functioning over time; women with higher intrusions at baseline started worse and improved over time, whereas those with lower intrusions remained at a constant, lower level over time. Intrusions were not associated with the trajectory of fatigue, sleep, breast cancer-specific symptoms, or mental functioning; women with higher intrusions at baseline started worse and remained worse over time. CONCLUSION: Intrusive thoughts are associated with enduring elevations in behavioral symptoms and impaired quality of life in the year after breast cancer treatment and may be a risk factor for poor outcomes.