Evidence Explorer · MS-N252 · Mind–body and sleep · insomnia with a primary brain tumor · Appraised November 6, 2026

A phase IIc randomized pilot found that six weekly telehealth group CBT-I sessions were feasible and acceptable for adults with primary brain tumors, with promising but not definitive symptom signals.

Evidence at a glance

• Benefit signal: Feasibility targets were met and descriptive insomnia improvements favored CBT-I.
• Certainty: Low. This was a 60-person feasibility pilot, not a confirmatory efficacy trial.
• Risk context: Sleep restriction and telehealth cognitive demands require adaptation for seizures, neurologic deficits, fatigue, fall risk and daytime safety.
• Cancer-control relevance: The study did not test tumor response, progression or survival.

What was studied

Sixty adults with a primary brain tumor and chronic insomnia were randomized to six weekly 90-minute telehealth group CBT-I sessions or treatment as usual (29 and 31 participants, respectively).

Feasibility and acceptability were primary. Symptom measures were exploratory; follow-up included week 6 and week 18.

What the study found

Retention was 86%. Every intervention respondent reported improved sleep and said they would recommend the program.

Descriptively, clinically meaningful acute improvements were more common with CBT-I than usual care for insomnia (61% versus 33%), fatigue (57% versus 35%) and sleep quality (74% versus 30%). Reported standardized effects favored CBT-I, but the pilot was not designed to establish definitive efficacy.

What this does not establish

Patient-reported outcome completion declined to 73% at week 6 and 68% at week 18. Small samples and feasibility-focused analyses produce imprecise estimates.

Results from participants able to join group telehealth may not generalize to people with greater cognitive, sensory or neurologic impairment.

Safety and practical context

A neuro-oncology team should review seizure control, corticosteroid timing, cognitive changes, falls and driving before sleep compression. A caregiver or individualized format may help when memory or executive function is impaired.

Worsening headaches, seizures, confusion or focal symptoms are not insomnia problems and require prompt medical assessment.

Questions for the care team

• Can the program accommodate cognitive, visual, hearing or language needs?
• How will seizure risk and daytime sleepiness be monitored?
• Would an individual or caregiver-supported format be safer than group telehealth?

Sources and identifiers

• Randomized phase IIc study — PMID 42819807
• Full text in PubMed Central
• ClinicalTrials.gov — NCT06439420

Funding and conflicts: The study reported National Cancer Institute support; authors reported no conflicts in the accessible full text.

Source access and dates: Full text and registry were appraised. 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.