title: Insomnia in elderly cancer survivors--a population-based controlled study of associations with lifestyle, morbidity, and psychosocial factors. Results from the Health Survey of North-Trøndelag County (HUNT-2). Insomnia in elderly cancer survivors.
abstract: OBJECTIVE
  To examine the associations among morbidity, lifestyle, psychosocial factors and insomnia symptoms in elderly (≥70 years) cancer survivors of the Health Survey of North-Trøndelag County (HUNT-2).
  
  
  METHODS
  Among 11,899 individuals aged≥70 years who participated in HUNT-2, 479 had been diagnosed with invasive primary cancer from 1-10 years previously. Each patient was randomly matched with three cancer-free controls (N=1,437). In this population-based cross-sectional survey, the sample consisted of 460 cancer survivors and 1,356 controls with complete dataset concerning insomnia symptoms. Data was collected by means of self-administered questionnaires, and descriptive statistics were used to analyse the data.
  
  
  RESULTS
  Survivors with insomnia symptoms (N=89, 19.3%, 95% CI 15.7-23.0%) evidenced a higher rate of musculo-skeletal diseases, increased gastro-intestinal symptoms, had fewer friends, and reported 'good health' less frequently than survivors without such symptoms (N=371). Survivors with insomnia symptoms reported more regular use of medication, problems with personal activities of daily living (P-ADL) and higher levels of anxiety and depression. When the survivors with insomnia were compared to 250 (18.4%, 95% CI 16.4-20.5%) controls with insomnia, the results were similar except for significantly more P-ADL problems among survivors. Five-step logistic regression analysis showed 16.6% explained variance where 'gastro-intestinal symptoms', 'daily use of medication' and 'anxiety' contributed significantly to insomnia symptoms.
  
  
  CONCLUSIONS
  Insomnia affects people physically, mentally and in their ability to perform ADL. Elderly cancer survivors with insomnia reported more physical and psychosocial problems compared to survivors without insomnia. Except for increased P-ADL problems, cancer survivors with insomnia reported similarly to cancer-free controls with insomnia.
authors.affiliation: Department of Clinical Cancer Research, The Norwegian Radium Hospital, University of Oslo, Oslo, Norway, ellen.karine.grov@hibu.no
authors.forename: Ellen Karine
authors.initials: EK
authors.lastname: Grov
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.forename: Alv A
authors.initials: AA
authors.lastname: Dahl
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology; D009664:Norway / Q000453:epidemiology; D012042:Registries; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*