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