Sleep disturbance in cancer patients.
Sleep difficulty is a prominent concern of cancer patients, yet there has been no large study of the prevalence and nature of sleep disturbance in cancer patients. This cross-sectional survey study examined: (a) the prevalence of reported sleep problems in patients attending six clinics at a regional cancer centre; (b) sleep problem prevalence in relation to cancer treatment; and (c) the nature of reported insomnia (type, duration, and associated factors). For three months, all patients attending clinics for breast, gastrointestinal, genitourinary, gynecologic, lung, and non-melanoma skin cancers were offered a brief sleep questionnaire. Response rate was 87%; the final sample size was 982. Mean age of respondents was 64.9 years (SD 12.5). The most prevalent problems were excessive fatigue (44% of patients), leg restlessness (41%). insomnia (31%), and excessive sleepiness (28%). Chi square tests showed significant variation among clinics in the prevalence of most sleep problems. The lung clinic had the highest or second-highest prevalence of problems. The breast clinic had a high prevalence of insomnia and fatigue. Recent cancer treatment was associated with excessive fatigue and hypersomnolence. Insomnia commonly involved multiple awakenings (76% of cases) and duration > or = 6 months (75% of cases). In 48% of cases, insomnia onset was reported to occur around the time of cancer diagnosis (falling within the period 6 months pre-diagnosis to 18 months post-diagnosis). The most frequently identified contributors to insomnia were thoughts, concerns, and pain/discomfort. In a multivariate logistic regression analysis, variables associated with increased odds of insomnia were fatigue, age (inverse relationship), leg restlessness, sedative/hypnotic use, low or variable mood, dreams, concerns, and recent cancer surgery. This study provides new information about sleep-related phenomena in cancer patients, information which will be useful in planning supportive care services for cancer patients.
Davidson
Judith R
JR
Department of Psychology, Queen's University, Kingston, Ont, Canada. davidsnj@post.queensu.ca
MacLean
Alistair W
AW
Brundage
Michael D
MD
Schulze
Karleen
K
D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D002173:Cancer Care Facilities; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000150:complications / Q000453:epidemiology; D005221:Fatigue / Q000150:complications / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000150:complications* / Q000503:physiopathology; D015995:Prevalence; D012148:Restless Legs Syndrome / Q000150:complications / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014149:Tranquilizing Agents / Q000627:therapeutic use
D014149:Tranquilizing Agents