Sleep disturbances and impaired daytime functioning in outpatients with newly diagnosed lung cancer.
BACKGROUND
Clinical experience suggests that lung cancer (LC) is associated with sleep disturbances that may contribute to impaired daytime functioning and quality of life. Using questionnaires and home actigraphic recordings, we tried to determine whether sleep quality and daytime alertness are impaired in patients with newly diagnosed LC.


METHODS
Twenty-nine outpatients with newly diagnosed LC and an Eastern Cooperative Oncology Group performance status </=2 and 14 age- and sex-matched non-cancer (NC) patients with successfully treated sleep apnea were enrolled in the study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and by night actigraphic data. Daytime alertness was assessed by the Epworth Sleepiness Scale (ESS) and day actigraphic data. The medical outcomes study 36-item short form (SF-36) was used for quality of life assessment.


RESULTS
LC patients had higher PSQI (9.6+/-3.7 versus 5.6+/-3.2; p<0.001) and higher ESS (8.6+/-3.7 versus 5.6+/-3.2; p=0.01) than NC patients indicating worse quality of sleep and more excessive daytime sleepiness. Both physical and mental components score of SF-36 were lower in LC patients (p<0.001) indicating lower quality of life. Wrist actigraphy data showed significantly lower sleep efficiency and a higher sleep fragmentation during the night and lower mean activity during the day in LC patients.


CONCLUSIONS
Patients with newly diagnosed LC and performance status </=2 present marked sleep disturbances, excessive daytime sleepiness and impaired quality of life. Further studies are required to determine the etiologic factors of sleep disturbances in LC patients and the impact of pharmacologic and non-pharmacologic interventions on sleep and daytime functioning.
Le Guen
Yannick
Y
Department of Pulmonary Medicine, CHU, Angers, France.
Gagnadoux
Frédéric
F
Hureaux
José
J
Jeanfaivre
Thierry
T
Meslier
Nicole
N
Racineux
Jean-Louis
JL
Urban
Thierry
T
D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D018288:Carcinoma, Small Cell / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D010045:Outpatients; D011788:Quality of Life; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000209:etiology / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis