title: Sleep Quality of Patients with Differentiated Thyroid Cancer.
abstract: OBJECTIVE
  We aimed to measure prevalence of sleep disturbance in patients with differentiated thyroid cancer (DTC) by calculating Pittsburgh Sleep Quality Index (PSQI), and compare these data with patients with benign thyroid nodules or normal participants.
  
  
  METHODS
  Three groups of patients participated in this cross-sectional study. In the first group, 162 patients with DTC received total thyroidectomy, and then 131I therapy. The second group consisted of 84 patients with benign thyroid nodules, who received partial thyroidectomy. The third group was 78 normal healthy control cases. PSQI was used to assess the sleep quality. Inter-group differences were analyzed by Kruskal-Wallis test or independent samples T test. χ2 test was also used to check prevalence differences of poor sleep quality among the groups. Differences of PSQI score and poor sleep quality prevalence before and after 131I therapy in the same group of DTC participants were analyzed by paired T test and Mcnemar's test.
  
  
  RESULTS
  Higher PSQI score (7.59 ± 4.21) and higher rate of poor sleep quality (54.32%) were shown in DTC patients than in any other group. After 131I therapy, PSQI score and prevalence of poor sleep quality in DTC patients increased significantly to 8.78 ± 4.72 and 70.99%. Then DTC patients were divided into two subgroups based on their metastatic status. DTC patients with metastasis (87/162 cases, 53.70%) had significantly higher PSQI score (10.87 ± 5.18) and higher prevalence of poor sleep quality (79.31%).
  
  
  CONCLUSIONS
  DTC patients suffer from sleep disturbance, 131I therapy and awareness of metastatic status could worsen sleep problem. Psychological fear of cancer, nuclear medicine therapy and metastasis could be one major underlying reason. Longitude and interventional studies are necessary for further investigations.
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Yajing
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Zhaowei
authors.initials: Z
authors.lastname: Meng
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Jia
authors.affiliation: Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Fang
authors.initials: F
authors.lastname: Hu
authors.affiliation: Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Xianghui
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Tan
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Guizhi
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Xue
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Health Management, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Health Management, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Lili
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Yuling
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Yumei
authors.initials: Y
authors.lastname: Qian
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Shuling
authors.initials: S
authors.lastname: Hou
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Hua
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Renfei
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Tianpeng
authors.initials: T
authors.lastname: Hu
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Na
authors.initials: N
authors.lastname: Liu
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Arun
authors.initials: A
authors.lastname: Upadhyaya
authors.affiliation: Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P. R. China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000556:secondary; D000328:Adult; D002454:Cell Differentiation; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D013964:Thyroid Neoplasms / Q000150:complications* / Q000473:pathology