Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Supportive Care in Cancer
Published in: Supportive Care in Cancer 4/2017

01-04-2017 | Original Article

Sleep disturbances in advanced cancer patients admitted to a supportive/palliative care unit

Authors: Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Francesco Masedu, Marco Valenti, Federica Aielli

Published in: Supportive Care in Cancer | Issue 4/2017

Login to get access

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.
Literature
1.
Mystakidou K, Parpa E, Tsilika E, Pathiaki M, Gennatas K, Smymiotis V, Vassilou Y (2007) The relationship of subjective sleep quality, pain, and quality of life in advanced cancer patients. Sleep 30:737–742CrossRef
2.
Nishiura M, Tamura A, Nagai H, Matsushima E (2015) Assessment of sleep disturbance in lung cancer patients: relationship between sleep disturbance and pain, fatigue, quality of life, and psychological distress. Palliat Support Care 13:575–581CrossRef
3.
Palesh OG, Roscoe JA, Mustian KM, Roth T, Savard J, Ancoli-Israel S, Heckler C, Purnell JQ, Janelsins MC, Morrow GR (2010) Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program. J Clin Oncol 8:292–298CrossRef
4.
Savard J, Morin CM (2001) Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 19:895–908CrossRef
5.
Renom-Guiteras A, Planas J, Farriols C, Mojal S, Miralles R, Silvent MA, Ruis-Ripoll AI (2014) Insomnia among patients with advanced disease during admission in a palliative care unit: a prospective observational study on its frequency and association with psychological, physical and environmental factors. BMC Palliat Care 13:40CrossRef
6.
Palesh OG, Roscoe JA, Mustian KM et al (2010) Prevalence, demographics, and psychological association of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program. J Clin Oncol 28:292–298CrossRef
7.
Mercadante S, Aielli F, Adile C, Ferrera P, Valle A, Cartoni C, Oizzuto M, Caruselli A, Parsi R, Cortegiani A, Masedu F, Valenti M, Ficorella C, Porzio G (2015) Sleep disturbances in patients with advanced cancer in different palliative care settings. J Pain Symptom Manag 50:786–792CrossRef
8.
Yennurajalingam S, Balachandran D, Pedraza Cardozo SL, Berg EA, Chisholm GB, Reddy A, DeLa Cruz V, Williams JL, Bruera E. (2015) Patient-reported sleep disturbance in advanced cancer: frequency, predictors and screening performance of the Edmonton Symptom Assessment System sleep item. BMJ Support Palliat Care.​ doi: 10.​1136/​bmjspcare-2015-000847
9.
Delgado-Guay M, Yennurajalingam S, Parson H, Palmer JL, Bruera E (2011) Association between self-reported sleep disturbances and other symptoms in patients with advanced cancer. J Pain Symptom Manag 41:819–827CrossRef
10.
Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2000) Athens sleep disturbance scale: validation of an instrument based on ICD-281 10 criteria. J Psychosom Res 48:555–560CrossRef
11.
Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2003) The diagnostic validity of the Athens insomnia scale. J Psycho Res 55:263–267CrossRef
12.
Herrmann C (1997) International experiences with the hospital anxiety and depression scale-a review of validation data and clinical results. J Psychosom Res 42:17–41CrossRef
13.
Yennurajalingam S, Chisholm G, Palla SL, Holmes H, Reuben JM, Bruera E. (2013) Self-reported sleep disturbances in patients with advanced cancer: frequency, intensity, and factors associated with response to outpatient supportive care consultation. A preliminary report. Palliat Support Care 1–9
14.
Mercadante S, Girelli D, Casuccio A (2004) Sleep disorders in advanced cancer patients: prevalence and factors associated. Support Care Cancer 12:355–359CrossRef
15.
Miaskowski C, Lee KA (1999) Pain, fatigue, and sleep disturbances in oncology outpatients receiving radioation therapy for bone metastasis. A pilot study J Pain Symptom Manage 17:320–332CrossRef
16.
Theobald DE. (2004) Cancer pain, fatigue, distress, and insomnia in cancer patients. Clin Cornerstone. Suppl 1D:S15–21.CrossRef
17.
Hsiao FH, Kuo WH, Jow GM, Chang KJ, Yang PS, Lam HB, Lee JJ, Huang CS, Liu YF, Lai YM (2014) Habitual sleep-wake behaviors and lifestyle as predictors of diurnal cortisol patterns in young breast cancer survivors: a longitudinal study. Psychoneuroendocrinology 53C:60–68
18.
Innominato PF, Roche VP, Palesh OG, Ulusakarya A, Spiegel D, Lévi FA (2014) The circadian timing system in clinical oncology. Ann Med 46:191–207CrossRef
19.
Brennan MJ, Lieberman JA (2009) Sleep disturbances in patients with chronic pain: effectively managing opioid analgesia to improve outcomes. Curr Med Res Opin 25:1045–1055CrossRef
20.
Rose AR, Catcheside PG, McEvoy RD et al (2014) Sleep disordered breathing and chronic respiratory failure in patients with chronic pain on long term opioid therapy. J Clin Sleep Med 10:847–852PubMedPubMedCentral
21.
Raj SX, Thronaes M, Brunelli C, Hjermstad MJ, Klepstad P, Kaasa S (2014) A cross-sectional study on prevalence of pain and breakthrough pain among an unselected group of outpatients in a tertiary cancer clinic. Support Care Cancer 22:1965–1971CrossRef
22.
Cheatle MD, Foster S, Pinkett A, Lesneski M, Qu D, Dhingra L (2016) Assessing and managing sleep disturbance in patients with chronic pain. Anesthesiol Clin 34:379–393CrossRef
23.
Smith MT, Haythornthwaite JA (2004) How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev 8:119–132CrossRef
24.
Roehrs TA, Bentley A, Bonnet M, Fahs J, Jeong DU, Lankford A, Link H, Morin C, Sateia M, Vitiello M, Keam S, Weitz M. (2009) Does effective management of sleep disorders improve pain symptoms? Drugs. 69 Suppl 2:5–11CrossRef
25.
Wang D, Teichtahl H (2007) Opioids, sleep architecture and sleep-disordered breathing. Sleep Med Rev 11:35–46CrossRef
26.
Finan PH, Goodin BR, Smith MT (2013) The association of sleep and pain: an update and path forward. J Pain 14:1539–1552CrossRef
27.
Yennurajalingam S, Williams JL, Chisholm G, Bruera E (2016) Effects of dexamethasone and placebo on symptom clusters in advanced cancer patients: a preliminary report. Oncologist 21:384–390CrossRef
Metadata
Title
Sleep disturbances in advanced cancer patients admitted to a supportive/palliative care unit
Authors
Sebastiano Mercadante
Claudio Adile
Patrizia Ferrera
Francesco Masedu
Marco Valenti
Federica Aielli
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 4/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3524-4

Other articles of this Issue 4/2017

Supportive Care in Cancer 4/2017 Go to the issue

Original Article

Predictors of response to corticosteroids for dyspnea in advanced cancer patients: a preliminary multicenter prospective observational study

Original Article

Nausea and disturbed sleep as predictors of cancer-related fatigue in breast cancer patients: a multicenter NCORP study

Original Article

Exploring the rationale, experience and impact of using Cancer Information and Support (CIS) services: an international qualitative study

Original Article

Staphylococcus lugdunensis infections, filling in the gaps: a 3-year retrospective review from a comprehensive cancer center

Original Article

Factors supporting cardiomyopathy screening among at-risk adult survivors of pediatric malignancies

Commentary

Brief supportive-expressive group therapy for partners of men with early stage prostate cancer: lessons learned from a negative randomized controlled trial
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits