title: Assessment of sleep disturbance in lung cancer patients: relationship between sleep disturbance and pain, fatigue, quality of life, and psychological distress.
abstract: OBJECTIVE
  We investigated the prevalence of sleep disturbance and psychological distress in lung cancer patients. We also examined the association between sleep disturbance and psychological distress, pain, fatigue, and quality of life in the same population.
  
  
  METHODS
  Fifty lung cancer patients were evaluated. Sleep disturbance was assessed using the Athens Sleep Insomnia Scale (AIS) and psychological distress using the Hospital Anxiety and Depression Scale (HADS). Quality of life (QOL), pain, and fatigue were assessed employing the European Organization of Research and Treatment Quality of Life Questionnaire-Cancer 30 (EORTC QLQ-C30).
  
  
  RESULTS
  We observed that 56% of lung cancer patients had sleep disturbance (AIS score ≥6) and 60% had psychological distress (total HADS score ≥11). Patients with sleep disturbance had a HADS score of 14.6 ± 5.8, a fatigue score of 45.3 ± 22.0, and a pain score of 27.2 ± 26.2. In contrast, patients without sleep disturbance had a lower HADS score of 9.9 ± 8.1 (p < 0.05) and a higher fatigue score of 28.5 ± 18.0 (p < 0.01) and a pain score of 8.7 ± 15.8 (p < 0.01). In addition, we found a lower QOL in patients with sleep disturbance (46.3 ± 20.2) than in those without (65.2 ± 20.7) (p < 0.05). We also observed a significant correlation between the AIS, HADS, fatigue, QOL, and pain scores.
  
  
  CONCLUSIONS
  Lung cancer patients suffered from combined symptoms related to sleep. Sleeping pills improved sleep induction but were not sufficient to provide sleep quality and prevent daytime dysfunction. Daytime dysfunction was specifically associated with psychological distress. Additionally, the type of sleep disturbance was related to other patient factors, including whether or not they received chemotherapy.
authors: Section of Liaison,Psychiatry and Palliative Medicine,Graduate School of Medical and Dental Sciences,Tokyo Medical and Dental University,Bunkyo-ku,Tokyo,Japan.
authors: Mare
authors: M
authors: Nishiura
authors: Center for Pulmonary Diseases,National Hospital Organization,Tokyo National Hospital,Kiyose-shi,Tokyo,Japan.
authors: Atsuhisa
authors: A
authors: Tamura
authors: Center for Pulmonary Diseases,National Hospital Organization,Tokyo National Hospital,Kiyose-shi,Tokyo,Japan.
authors: Hideaki
authors: H
authors: Nagai
authors: Section of Liaison,Psychiatry and Palliative Medicine,Graduate School of Medical and Dental Sciences,Tokyo Medical and Dental University,Bunkyo-ku,Tokyo,Japan.
authors: Eisuke
authors: E
authors: Matsushima
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D004358:Drug Therapy; D064420:Drug-Related Side Effects and Adverse Reactions / Q000150:complications; D020920:Dyssomnias / Q000150:complications / Q000209:etiology*; D005221:Fatigue / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000150:complications* / Q000523:psychology; D008297:Male; D010146:Pain / Q000150:complications*; D011788:Quality of Life / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications*; D012893:Sleep Wake Disorders / Q000150:complications / Q000209:etiology*; D011795:Surveys and Questionnaires
keywords: Fatigue; Lung cancer; Psychological distress; Quality of life; Sleep disturbance