title: Insomnia and its associations in patients with recurrent glial neoplasms.
abstract: BACKGROUND
  Patient with neurological disorders and cancer can develop sleep disturbance, in particular insomnia. Etiology of insomnia is multi-factorial in primary brain tumour patients with possible causes including corticosteroids, psychoactive medications, co-morbid psychiatric/medical conditions, and damage to neuronal tissue.
  
  
  RESULTS
  To understand better insomnia in recurrent glioma patients, a single-center retrospective analysis was performed looking at recurrent glioma patients from January 2004 to May 2009. Data was extracted and included demographics, clinical factors, psychoactive medications, and co-morbid symptoms. Presence and absence of insomnia complaints was evaluated with other co-morbidities using Chi square and Wilcoxon analyses. Records from 340 recurrent glioma patients were evaluated and 46.8 % (n = 159) indicated presence of insomnia with 20 % (n = 66) actively using medications for sleep. Use of corticosteroids were significantly associated with insomnia (p = 0.0003). Age, gender, tumour location, use of stimulants, antipsychotics, and antidepressants were not significantly associated with insomnia in recurrent glioma patients. There was a trend towards a possible significant association with insomnia to fatigue complaints and use of anti-epileptics, p-values of 0.0501 and 0.0725 respectively.
  
  
  CONCLUSIONS
  In conclusion, insomnia is commonly encountered in patients with recurrent glial tumors. Corticosteroid use is associated with insomnia in this population. In light of the frequency of insomnia and its associations, future analysis is warranted into sleep complaints in recurrent glioma patients and its impact on quality of life.
authors.affiliation: Departments of Neurology, Portsmouth Regional Hospital, Portsmouth, NH USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Robertson
authors.affiliation: Biostatistics, Duke University Medical Center, Durham, NC USA.
authors.forename: Frances
authors.initials: F
authors.lastname: McSherry
authors.affiliation: Biostatistics, Duke University Medical Center, Durham, NC USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Herndon
authors.affiliation: Neurology, Duke University Medical Center, PO Box 3624, Durham, NC 27710 USA.
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Peters
keywords: Glial; Insomnia; Neoplasms; Recurrent