title: Sleep disturbances in advanced cancer patients admitted to a supportive/palliative care unit.
abstract: The aim of this study was to assess the prevalence of sleep disturbances and possible correlations with associated factors in a sample of patients admitted to an acute palliative/supportive care unit.A consecutive sample of patients with advanced cancer was prospectively assessed for a period of 6 months. Epidemiological and clinical data, treatments received in the last month, Karnofsky status, Edmonton Symptom Assessment System (ESAS), and concomitant medical treatment were also recorded. Patients were administered the Athens Insomnia Scale (AIS) and the Hospital Anxiety and depression scale (HADS).Two hundred nineteen patients met the inclusion criteria. The mean age was 65.4 years (SD 12.4), and 111 patients were males. The mean Karnofsky status was 46.6 (SD = 12). All patients had consistent sleep disturbances (AIS ≥6), with a large number of patients having intense-maximum sleep disturbances. No relationships of AIS with gender, age, primary diagnosis, socio-educational factors, and anticancer treatments were found. AIS score was significantly associated with Karnofsky; intensities of pain, asthenia, anorexia, anxiety, depression, drowsiness, and well-being; and the use of corticosteroids and benzodiazepines. There was a positive correlation of HADS anxiety and HADS depression with sleep disturbances (p = 0.000). In the multivariate analysis, AIS increased only with the level of anxiety and depression assessed by HADS.Sleep disturbances were ubiquitous in advanced cancer patients admitted to a supportive/palliative care unit and were strongly correlated with psychological distress. Assessment of sleep disorders is mandatory in this population for the obvious interference with quality of life.
authors.affiliation: Pain relief and supportive care unit, La Maddalena Cancer Center, Via San Lorenzo 312, 90146, Palermo, Italy. terapiadeldolore@lamaddalenanet.it.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Mercadante
authors.affiliation: Pain relief and supportive care unit, La Maddalena Cancer Center, Via San Lorenzo 312, 90146, Palermo, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Adile
authors.affiliation: Pain relief and supportive care unit, La Maddalena Cancer Center, Via San Lorenzo 312, 90146, Palermo, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ferrera
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L'Aquila, L'Aquila, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Masedu
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L'Aquila, L'Aquila, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Valenti
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L'Aquila, L'Aquila, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Aielli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000473:pathology; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: Advanced cancer; Insomnia; Palliative care; Sleep disturbances