title: Insomnia in patients with advanced cancer.
abstract: BACKGROUND
  Insomnia is underrecognized in patients with cancer. By identifying clinical correlations and predisposing factors of insomnia, interventions may be initiated to treat insomnia.
  
  
  METHODS
  Consecutive patients referred to palliative medicine services were screened with a single question. Patients answering affirmatively completed the Insomnia Severity Index (ISI). Patients were screened for depression, fatigue, and pain. Spearman correlation was performed for associations.
  
  
  RESULTS
  Of 715 consecutive patients, 102 had sleep problems and 64 had clinical insomnia by the ISI criteria. Insomnia correlated with depression (r = .32), pain (r = .29), and tiredness (r = .40) but not with age or precipitating factors.
  
  
  CONCLUSIONS
  Insomnia severity moderately correlates with depression, pain, and tiredness. We found no association of insomnia severity with age or medications.
  
  
  CONCLUSIONS
  Insomnia, pain, depression, and tiredness are a symptom cluster.
authors.affiliation: 1Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Center, Cleveland, OH, USA.
authors.forename: Mellar P
authors.initials: MP
authors.lastname: Davis
authors.forename: Dilara
authors.initials: D
authors.lastname: Khoshknabi
authors.forename: Declan
authors.initials: D
authors.lastname: Walsh
authors.forename: Ruth
authors.initials: R
authors.lastname: Lagman
authors.forename: Alexandra
authors.initials: A
authors.lastname: Platt
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*
keywords: depression; fatigue; insomnia; pain; sleep severity