1 Hematological cancers, a group of cancer sub-types that include blood- and lymph-related disorders (i.e.,
2 leukemia, lymphoma, myeloma, myeloproliferative neoplasms (MPNs) and myelodysplastic syndromes (MDS),
3 account for 11% of all cancer diagnoses in the US. Chronic hematological cancer (CHC) patients (i.e., chronic
4 leukemias, low grade lymphomas, myeloma, myelodysplastic syndrome, and myeloproliferative neoplasms
5 [MPNs]) have extended disease courses that are often different from solid tumor cancers, facing chronic sleep
6 disturbances often associated with inflammation, fatigue, and emotional distress (anxiety and depression), which
7 often persist into survivorship. Medications are most commonly prescribed for cancer patients with sleep
8 disturbance; however, they often come with side effects and risk for long-term dependence. Cognitive behavioral
9 therapy for insomnia (CBT-I) is the most studied and first line of therapy for treating sleep disturbances in cancer
10 patients, but CBT-I is time-consuming, resource-intensive, and not easily accessible for all cancer patients. There
11 is a need for long-term, accessible, non-pharmacologic interventions targeting sleep in CHC patients.
12 Meditation is a safe and effective non-pharmacologic approach for improving a range of cancer-related
13 symptoms. However, meditation interventions have typically been delivered in-person, limiting uptake and
14 widespread dissemination due to patient-reported barriers. Smartphone applications (apps) are a novel
15 intervention approach for delivering meditation and address cancer patients’ barriers to participating in in-person
16 interventions (i.e., fatigue, pain, transportation, and scheduling difficulties) without the time and expertise
17 limitations of CBT-I and side effect risks from medication. Calm is a popular and highly reviewed consumer-
18 based smartphone app that provides an innovative, accessible and scalable platform through which to deliver
19 meditation to CHC patients.
20 We propose a double-blind RCT to determine the effectiveness of an eight-week “app-based wellness”
21 intervention (i.e., active daily meditation intervention [Calm] or the placebo health education podcast control
22 group [POD]) to reduce sleep disturbance (primary outcome), markers of inflammation (TNF-a, IL-6, IL-8, and
23 CRP) fatigue, and emotional distress (anxiety, depression) (secondary outcomes) in CHC patients.
24 Assessments will occur at baseline, post-intervention (eight weeks from baseline), and follow-up (20 weeks from
25 baseline). Participants (N=276) will be randomized to an intervention (10 min/day Calm meditation) (n=138) or
26 control (10 min/day health education podcast) group (n=138). We will remotely collect blood samples for
27 biomarker measurement. This study will fill a knowledge and rigor gap regarding the delivery of smartphone-
28 based meditation as an intervention for sleep and provide new data on sustained effects in CHC patients to
29 reduce sleep disturbance.