title: Sleep Disturbances in Patients With Advanced Cancer in Different Palliative Care Settings.
abstract: BACKGROUND
  Information regarding sleep disturbances in the population with advanced cancer is meager.
  
  
  OBJECTIVE
  To assess the prevalence of sleep disturbances and possible correlations with associated factors in a large number of patients with advanced cancer admitted to different palliative care settings.
  
  
  METHODS
  This was an observational study performed in different settings of palliative care. A consecutive sample of patients with advanced cancer was prospectively assessed for a period of six months. Epidemiological and clinical data, treatments received in the last month, Karnofsky status, Edmonton Symptom Assessment System scores, and concomitant medical treatment were recorded. Patients were administered the Athens Insomnia Scale and the Hospital Anxiety and Depression Scale (HADS).
  
  
  RESULTS
  A total of 820 patients were surveyed. Mean age was 69.7 years (SD 12.7), and 429 patients were males. Consistent sleep disturbances (moderate to maximum) were found in 60.8% of patients. Aged patients were less likely to have sleep disturbances, whereas a poor Karnofsky level was significantly associated with sleep problems. Breast, gastrointestinal, head and neck, lung, and prostate cancers were associated with sleep problems. Patients who had a secondary school or undergraduate education had less sleep disturbances. Hormone therapy and use of opioids and corticosteroids were positively associated with sleep disturbances, and there was a positive correlation of HADS-Anxiety and HADS-Depression scores with sleep disturbances.
  
  
  CONCLUSIONS
  More than 60% of palliative care patients have relevant sleep disturbances. Several factors associated with sleep disorders have been identified and should prompt physicians to make a careful examination and subsequent treatment of these disturbances.
authors: Pain Relief and Supportive Care Unit, La Maddalena Cancer Center, Palermo, Italy. Electronic address: terapiadeldolore@lamaddalenanet.it.
authors: Sebastiano
authors: S
authors: Mercadante
authors: Supportive Care Task Force, University of L'Aquila, L'Aquila, Italy.
authors: Federica
authors: F
authors: Aielli
authors: Pain Relief and Supportive Care Unit, La Maddalena Cancer Center, Palermo, Italy.
authors: Claudio
authors: C
authors: Adile
authors: Pain Relief and Supportive Care Unit, La Maddalena Cancer Center, Palermo, Italy.
authors: Patrizia
authors: P
authors: Ferrera
authors: Hospice and Home Care Program, FARO Foundation, Turin, Italy.
authors: Alessandro
authors: A
authors: Valle
authors: Division of Hematology, Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I, Home Care Service of the Rome Section of the Italian Association Against Leukemias, Rome, Italy.
authors: Claudio
authors: C
authors: Cartoni
authors: Palliative Care Unit, Istituti Clinici di Perfezionamento Hospital, Milan, Italy.
authors: Massimo
authors: M
authors: Pizzuto
authors: Home Care Program, SAMO, Palermo, Italy; Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico "P. Giaccone", University of Palermo, Palermo, Italy.
authors: Amanda
authors: A
authors: Caruselli
authors: Home Care Program, SAMO, Palermo, Italy.
authors: Renato
authors: R
authors: Parsi
authors: Department of Biopathology, Medical and Forensic Biotechnologies, Policlinico "P. Giaccone", University of Palermo, Palermo, Italy.
authors: Andrea
authors: A
authors: Cortegiani
authors: Section of Clinical Epidemiology and Environmental Medicine, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
authors: Francesco
authors: F
authors: Masedu
authors: Section of Clinical Epidemiology and Environmental Medicine, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
authors: Marco
authors: M
authors: Valenti
authors: Supportive Care Task Force, University of L'Aquila, L'Aquila, Italy.
authors: Corrado
authors: C
authors: Ficorella
authors: Supportive Care Task Force, University of L'Aquila, L'Aquila, Italy.
authors: Giampiero
authors: G
authors: Porzio
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D020249:Hormone Replacement Therapy / Q000379:methods / Q000706:statistics & numerical data; D006738:Hospices / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data; D010166:Palliative Care / Q000379:methods* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D012959:Socioeconomic Factors
keywords: Sleep disturbances; advanced cancer; insomnia; palliative care