Predictors of poor sleep quality among head and neck cancer patients.
OBJECTIVE
The objective of this study was to determine the predictors of sleep quality among head and neck cancer patients 1 year after diagnosis.


METHODS
This was a prospective, multisite cohort study of head and neck cancer patients (N = 457).


METHODS
Patients were surveyed at baseline and 1 year after diagnosis. Chart audits were also conducted. The dependent variable was a self-assessed sleep score 1 year after diagnosis. The independent variables were a 1 year pain score, xerostomia, treatment received (radiation, chemotherapy, and/or surgery), presence of a feeding tube and/or tracheotomy, tumor site and stage, comorbidities, depression, smoking, problem drinking, age, and sex.


RESULTS
Both baseline (67.1) and 1-year postdiagnosis (69.3) sleep scores were slightly lower than population means (72). Multivariate analyses showed that pain, xerostomia, depression, presence of a tracheotomy tube, comorbidities, and younger age were statistically significant predictors of poor sleep 1 year after diagnosis of head and neck cancer (P < .05). Smoking, problem drinking, and female sex were marginally significant (P < .09). Type of treatment (surgery, radiation and/or chemotherapy), primary tumor site, and cancer stage were not significantly associated with 1-year sleep scores.


CONCLUSIONS
Many factors adversely affecting sleep in head and neck cancer patients are potentially modifiable and appear to contribute to decreased quality of life. Strategies to reduce pain, xerostomia, depression, smoking, and problem drinking may be warranted, not only for their own inherent value, but also for improvement of sleep and the enhancement of quality of life.
Shuman
Andrew G
AG
Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.
Duffy
Sonia A
SA
Ronis
David L
DL
Garetz
Susan L
SL
McLean
Scott A
SA
Fowler
Karen E
KE
Terrell
Jeffrey E
JE
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000209:etiology*; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014140:Tracheotomy / Q000706:statistics & numerical data; D014987:Xerostomia / Q000453:epidemiology