title: Self-reported rates of sleep disturbance in patients with symptomatic bone metastases attending an outpatient radiotherapy clinic.
abstract: OBJECTIVE
  To examine the reported rates and predictive factors for sleep disturbance in patients with bone metastases.
  
  
  METHODS
  Patients with symptomatic bone metastases treated with palliative radiotherapy (RT) were eligible. At initial consultation, demographic information, baseline Brief Pain Inventory (BPI) questionnaire, and analgesic consumption were recorded. The BPI functional interference sleep item was categorized into none (0), mild (1-3), moderate (4-6), and severe (7-10). Follow-up BPI was collected in person or via telephone post-RT at week 4, 8, and 12. Subgroup analysis for BPI between responders and nonresponders was performed. Ordinal logistic regression analysis was used to search for the relationship between sleep disturbance and other covariates.
  
  
  RESULTS
  Four hundred patients were enrolled between May 2003 and June 2007. Two hundred thirty-five males (59%) were accrued. The median age was 68 years old (range, 30-91). Within the study population, primary cancer sites included breast (25%), lung (25%), prostate (24%), bladder (4%), pancreas/gastric (3%), and other primaries (18%). In the BPI functional interference items, the mean baseline score for sleep disturbance was 4.8. When categorized in terms of severity, 99 (25%) patients had moderate sleep disturbance and 144 (36%) patients had severe sleep disturbance, respectively. There was an improvement in sleep scores for both responders and nonresponders at week 4 and 8, but scores worsened for nonresponders at week 12.
  
  
  CONCLUSIONS
  Age, Karnofsky Performance Scale (KPS), pain score, and lung primary were the significant variables associated with sleep disturbance. The scores for sleep disturbance improved significantly post-RT in responders at week 4 and 12.
authors.affiliation: Rapid Response Radiotherapy Program, Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Luluel
authors.initials: L
authors.lastname: Khan
authors.forename: Cassandra
authors.initials: C
authors.lastname: Uy
authors.forename: Janet
authors.initials: J
authors.lastname: Nguyen
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.forename: Liang
authors.initials: L
authors.lastname: Zeng
authors.forename: Nadia
authors.initials: N
authors.lastname: Salvo
authors.forename: Shaelyn
authors.initials: S
authors.lastname: Culleton
authors.forename: Florencia
authors.initials: F
authors.lastname: Jon
authors.forename: Karrie
authors.initials: K
authors.lastname: Wong
authors.forename: Cyril
authors.initials: C
authors.lastname: Danjoux
authors.forename: May
authors.initials: M
authors.lastname: Tsao
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barnes
authors.forename: Arjun
authors.initials: A
authors.lastname: Sahgal
authors.forename: Lori
authors.initials: L
authors.lastname: Holden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001842:Bone and Bones / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000532:radiotherapy*; D009864:Ontario / Q000453:epidemiology; D010361:Patients / Q000523:psychology*; D057566:Self Report; D012893:Sleep Wake Disorders / Q000453:epidemiology*