Systematic adaptation of ProSleep for men initiating androgen-deprivation therapy for prostate cancer: development of ProSleep-Pro
Résumé fourni par la source
Background: Androgen-deprivation therapy (ADT) is a cornerstone of prostate cancer treatment but frequently causes vasomotor symptoms, fatigue, nocturia, and behavioral changes that disrupt sleep early in treatment. Few interventions specifically address sleep during the transition to ADT, before persistent sleep disturbances become established. ProSleep is a brief multimodal sleep-support intervention originally developed for adults recovering from intensive hematological cancer treatments. Adaptation was needed for men initiating ADT given differences in treatment trajectory, symptom burden, care setting, and preferences. Objective: To systematically adapt ProSleep to the clinical and psychosocial context of men initiating ADT while preserving its core behavioral principles. Methods: A structured, evidence-informed adaptation integrated four sources: (1) the original ProSleep intervention and preliminary findings; (2) the Canadian Urological Association guideline on ADT-related adverse effects; (3) evidence on sleep interventions and preferences among men with prostate cancer; and (4) iterative feedback from a patient partner with lived experience of prostate cancer and ADT. Multidisciplinary expertise informed adaptations to content, delivery, examples, and symptom-management strategies. Modifications and their supporting rationale were systematically documented. Results: ProSleep-Pro retained three core elements: individualized behavioral sleep support, audio-guided self-regulation, and brief professional follow-up. Adaptations addressed ADT-specific sleep disruptors, including hot flashes/night sweats, fatigue, nocturia, and circadian disruption; added a hypnosis-based audio script targeting vasomotor symptoms; tailored sleep plans to ADT-related symptoms and routines; and adapted delivery for ambulatory oncology care. The three-week intervention combines individualized sleep hygiene and stimulus control, symptom-specific audio-guided self-regulation, and brief follow-up. Conclusion: ProSleep-Pro is a systematically adapted intervention for early sleep support during ADT. The adaptation preserved ProSleep’s core behavioral functions while tailoring content and delivery to ADT-related symptoms, clinical guidance, patient preferences, and lived experience. Feasibility testing will assess acceptability, adherence, delivery feasibility, and the clinical profile of men most likely to benefit before efficacy testing.
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