title: Sleep disturbances and quality of life in postoperative management after esophagectomy for esophageal cancer.
abstract: BACKGROUND
  The aims of this prospective study were to analyze the predictors of postoperative sleep disturbance after esophagectomy for cancer and to identify patients at risk for postoperative hypnotic administration.
  
  
  METHODS
  Sixty two consecutive patients who underwent cancer-related esophagectomy were enrolled in this study from May 2011 to February 2012. Data about perioperative management, postoperative complications, ICU stay, and vasopressor, hypnotic, and painkiller administration were retrieved. The EORTC QLQ-C30 was used and global quality of life (QL2 item) and sleep disturbance (SL item) were the primary endpoints. Univariate and multivariate analyses were performed.
  
  
  RESULTS
  Postoperative request of hypnotics independently predicted bad quality of life outcome. Sleep disturbance after esophagectomy was independently predicted by the duration of dopamine infusion in the ICU and the daily request of benzodiazepines. Even in this case, only sleep disturbance at diagnosis revealed to be an independent predictor of hypnotic administration need. ROC curve analysis showed that sleep disturbance at diagnosis was a good predictor of benzodiazepine request (AUC = 73%, P = 0.02).
  
  
  CONCLUSIONS
  The use of vasopressors in the ICU affects sleep in the following postoperative period and the use of hypnotics is neither completely successful nor lacking in possible consequences. Sleep disturbance at diagnosis can successfully predict patients who can develop sleep disturbance during the postoperative period.
authors.affiliation: Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), via Gattamelata 64, 35128 Padova, Italy. marcoscarpa73@yahoo.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Scarpa
authors.forename: Eleonora
authors.initials: E
authors.lastname: Pinto
authors.forename: Luca M
authors.initials: LM
authors.lastname: Saadeh
authors.forename: Matteo
authors.initials: M
authors.lastname: Parotto
authors.forename: Anna
authors.initials: A
authors.lastname: Da Roit
authors.forename: Elisa
authors.initials: E
authors.lastname: Pizzolato
authors.forename: Rita
authors.initials: R
authors.lastname: Alfieri
authors.forename: Matteo
authors.initials: M
authors.lastname: Cagol
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Saraceni
authors.forename: Fabio
authors.initials: F
authors.lastname: Baratto
authors.forename: Carlo
authors.initials: C
authors.lastname: Castoro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D004938:Esophageal Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy* / Q000209:etiology; D011795:Surveys and Questionnaires
chemical_list: D006993:Hypnotics and Sedatives