Evidence Explorer · MS-N253 · Mind–body and sleep · sleep and emotional recovery after gastric-cancer surgery · Appraised November 6, 2026
A five-session psychological program combining CBT-I with resilience and narrative therapy improved sleep, anxiety, depression and global quality of life three months after curative-intent gastrectomy in one randomized trial.
Evidence at a glance
- Benefit signal: Clinically notable short-term sleep improvement with parallel emotional and quality-of-life benefits.
- Certainty: Moderate for the combined program at three months; low for any individual component or longer-term effect.
- Risk context: No serious adverse events were reported, but sleep scheduling and emotionally focused therapy require individual adaptation.
- Cancer-control relevance: This was perioperative supportive care; it did not establish recurrence or survival benefit.
What was studied
A prospective randomized trial assigned 260 people with stage I–III gastric cancer scheduled for curative gastrectomy 1:1 to usual perioperative care or five weekly sessions combining CBT-I with resilience and narrative-therapy modules. All participants received individualized nutritional optimization.
The primary endpoint was Pittsburgh Sleep Quality Index score at three months. Secondary endpoints included global health/quality of life, anxiety and depression.
What the study found
Of 260 randomized participants, 240 completed follow-up. The adjusted sleep-score difference was −3.0 points (95% CI −3.8 to −2.2; p<.001).
Global health/quality of life improved by 7.8 points (95% CI 5.1 to 10.5), anxiety by −3.8 (95% CI −5.4 to −2.2) and depression by −3.6 (95% CI −5.2 to −2.0). No serious intervention-related adverse events were reported.
What this does not establish
Because the intervention bundled CBT-I, resilience work and narrative therapy, the trial cannot identify which component produced benefit. The three-month endpoint does not establish durability.
Results from one perioperative program may not transfer to metastatic disease, nonsurgical care or other health systems.
Safety and practical context
After gastrectomy, sleep can be disrupted by pain, reflux, dumping symptoms, nutrition, anemia and medication timing; these causes need treatment alongside behavioral care.
Emotion-focused work can temporarily increase distress. A trained professional should recognize severe depression, suicidality, delirium or trauma reactions that need more intensive care.
Questions for the care team
- Which postoperative symptoms are disrupting sleep, and are they being treated?
- Is the available program comparable to the studied combined intervention?
- How will mood deterioration or severe nutritional problems be escalated?
Sources and identifiers
Funding and conflicts: Funding and complete conflict information were not fully verified from the accessible abstract.
Source access and dates: Primary abstract was appraised; the full intervention manual and detailed adverse-event tables were not independently verified. Sources checked November 6, 2026. Last literature search November 6, 2026.
Educational evidence summary, not individualized medical advice. Psychological and sleep interventions should complement—not replace—oncology, palliative, mental-health or sleep-medicine care.
