title: Sleeping with the enemy: sleep and quality of life in patients with lung cancer.
abstract: BACKGROUND
  Patients with lung cancer have the poorest sleep quality compared with other patients with cancer and noncancer control subjects. However, few studies have examined sleep longitudinally.
  
  
  OBJECTIVE
  The objective of this study was to characterize and correlate sleep quality, daytime sleepiness, sleep-wake actigraphy, and quality of life (QOL) before, during, and after chemotherapy for non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Using a prospective repeated-measures 1-group design, patients scheduled to receive chemotherapy for NSCLC were recruited. Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Functional Assessment of Cancer Treatment-Lung (FACT-L), and Motionlogger Actigraph were used for data collection.
  
  
  RESULTS
  Poor nocturnal sleep and QOL were evident among 29 patients with NSCLC before treatment. The FACT-L subscale scores worsened and then improved significantly from baseline through 2 rounds of chemotherapy. Objective sleep duration and sleep efficiency were positively associated with FACT-L scores, whereas objective sleep latency and wake after sleep onset were negatively associated with FACT-L scores. Sleepy patients had significantly worse FACT-L scores than did nonsleepy patients. The FACT-L subscale items that demonstrated significant worsening and then improvement over time were shortness of breath, weight loss, coughing, and chest tightness. Lung cancer patients experience early and middle insomnia before and during treatment.
  
  
  CONCLUSIONS
  Poor sleep quality is common in patients receiving treatment for NSCLC and is related to poorer QOL and respiratory symptoms.
  
  
  CONCLUSIONS
  Patients with NSCLC require routine screening for sleep disturbances. A positive screen for sleep disturbance warrants a thorough sleep assessment using practice guidelines and, if necessary, referral to a sleep specialist for diagnosis and treatment.
authors.affiliation: Author Affiliations: School of Nursing (Dr Dean, Ms Abu Sabbah, Dr Dickerson) and School of Medicine (Dr Steinbrenner), University at Buffalo, State University of New York; VA Western New York Health Systems (Ms Ziegler, Dr Steinbrenner); Department of Medicine, Thoracic Oncology, Buffalo (Dr Chen); Boromrajjonnani College of Nursing at Saraburi, Thailand (Dr Yingrengreung).
authors.forename: Grace E
authors.initials: GE
authors.lastname: Dean
authors.forename: Eman
authors.initials: E
authors.lastname: Abu Sabbah
authors.forename: Siritorn
authors.initials: S
authors.lastname: Yingrengreung
authors.forename: Patricia
authors.initials: P
authors.lastname: Ziegler
authors.forename: Hongbin
authors.initials: H
authors.lastname: Chen
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Steinbrenner
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Dickerson
mesh_terms: D056044:Actigraphy; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D012893:Sleep Wake Disorders / Q000150:complications* / Q000209:etiology