Prevalence of Sleep Disturbance and the Impact of Psychologist Delivered Cognitive Behavioural Therapy in Newly Diagnosed Cancer Patients: A Prospective Single-Centre Study from Saudi Arabia

Background. Sleep disturbance is among the most prevalent and undertreated symptoms in patients with cancer, yet data from Middle Eastern oncology settings are scarce. Cognitive behavioural therapy for insomnia (CBT-I) is the guideline-endorsed first-line treatment but is rarely operationalised as a routine psychologist-delivered service in the region.
Objective. To determine the prevalence of clinically significant sleep disturbance among newly diagnosed cancer patients at a single tertiary centre and to evaluate the short-term impact of a psychologist-delivered CBT/CBT-I intervention on sleep outcomes.
Methods. Prospective single-centre observational study of 99 consecutive newly diagnosed cancer patients treated at the Armed Forces Hospital, Southern Region, Saudi Arabia, between December 2023 and June 2024. Patients were screened for sleep disturbance at each treatment cycle; those screening positive underwent structured clinical and psychological assessment, and confirmed cases received manualised, psychologist-delivered CBT/CBT-I. Outcomes were graded as complete resolution, moderate improvement, or no improvement. Proportions are reported with 95% Wilson confidence intervals (CI).
Results. Sleep disturbance was screen-positive in 27/99 patients (27.3%; 95% CI 19.5–36.8) and confirmed in 20 (20.2% of the cohort; 95% CI 13.5–29.2). Emotional instability was the most frequently identified contributor (9/20; 45.0%), followed by pain (4/20; 20.0%). Anxiety or depressed mood was reported by 44.4% of affected patients. Following CBT, any degree of sleep improvement occurred in 13/20 patients (65.0%; 95% CI 43.3–81.9), comprising complete resolution in 3 (15.0%; 95% CI 5.2–36.0) and moderate improvement in 10 (50.0%); 7 (35.0%) showed no improvement. The proportion achieving any improvement significantly exceeded the pre-specified 10% quality-improvement target (exact binomial p < 0.001).

Conclusions. Clinically significant sleep disturbance affected approximately one in five newly diagnosed cancer patients and was strongly linked to psychological distress. A psychologist-delivered CBT service produced improvement in roughly two-thirds of treated patients, supporting the feasibility and value of embedding evidence-based behavioural sleep care within routine oncology practice. The single-arm design and small sample warrant confirmation in controlled studies using validated instruments.