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Published in: Supportive Care in Cancer 9/2019

01-09-2019 | Prostate Cancer | Original Article

Problems sleeping with prostate cancer: exploring possible risk factors for sleep disturbance in a population-based sample of survivors

Authors: Rebecca Maguire, Frances J. Drummond, Paul Hanly, Anna Gavin, Linda Sharp

Published in: Supportive Care in Cancer | Issue 9/2019

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Abstract

Purpose

This study aimed to investigate the prevalence of sleeping problems in prostate cancer survivors and to explore the role of predisposing, precipitating and perpetuating factors in this process.

Methods

Using a cross-sectional design, 3348 prostate cancer survivors between 2 and 18 years post diagnosis reported experiences of insomnia using the QLQC30, along with their sociodemographic characteristics, health status and treatment(s) received. The EQ5D-5L and QLQPR25 assessed survivors’ overall and prostate cancer–specific health-related quality of life. A hierarchical multiple regression analysis was constructed with three blocks: (1) predisposing (e.g. demographics at diagnosis), (2) precipitating (e.g. disease extent, treatment) and (3) perpetuating factors (e.g. side effects).

Results

Nineteen percent of survivors reported significant problems sleeping. The final model accounted for 31% of the variance in insomnia scores (p < .001). In order of magnitude, associates of sleep disturbance were urinary symptoms (β = 0.22; p < .001), experiencing symptoms of depression/anxiety (β = 0.18; p < .001), hormone treatment–related symptoms (β = 0.12; p = .001), pain (β = 0.10; p < .001) and bowel symptoms (β = 0.06; p = .005). Having a lower education and more comorbidities at diagnosis also predicted sleep problems.

Conclusion

Results suggest that it is the ongoing adverse effects of prostate cancer and its treatment (e.g. urinary symptoms) that put survivors most at risk of sleep problems. Strong associations with symptoms of depression/anxiety were also observed. Findings highlight the need for health care practitioners to treat and manage adverse effects of prostate cancer treatment in order to mitigate sleep disturbance in survivors.
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Literature
2.
go back to reference Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS, Mahadevan A, Klein E, Kibel A, Pisters LL, Kuban D, Kaplan I, Wood D, Ciezki J, Shah N, Wei JT (2008) Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med 358(12):1250–1261. https://doi.org/10.1056/NEJMoa074311 CrossRefPubMed Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS, Mahadevan A, Klein E, Kibel A, Pisters LL, Kuban D, Kaplan I, Wood D, Ciezki J, Shah N, Wei JT (2008) Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med 358(12):1250–1261. https://​doi.​org/​10.​1056/​NEJMoa074311 CrossRefPubMed
3.
go back to reference Litwin MS, Hays RD, Fink A, Ganz PA, Leake B, Leach GE, Brook RH (1995) Quality-of-life outcomes in men treated for localized prostate cancer. Jama 273(2):129–135CrossRefPubMed Litwin MS, Hays RD, Fink A, Ganz PA, Leake B, Leach GE, Brook RH (1995) Quality-of-life outcomes in men treated for localized prostate cancer. Jama 273(2):129–135CrossRefPubMed
4.
go back to reference Drummond FJ (2016) Are we sleeping on the job? Insomnia among men with prostate cancer. Adv Mod Oncol Res 2:74CrossRef Drummond FJ (2016) Are we sleeping on the job? Insomnia among men with prostate cancer. Adv Mod Oncol Res 2:74CrossRef
11.
go back to reference Roth T, Franklin M, Bramley TJ (2007) The state of insomnia and emerging trends. Am J Manag Care 13(5 Suppl):S117–S120PubMed Roth T, Franklin M, Bramley TJ (2007) The state of insomnia and emerging trends. Am J Manag Care 13(5 Suppl):S117–S120PubMed
14.
go back to reference Miaskowski C, Paul SM, Cooper BA, Lee K, Dodd M, West C, Aouizerat BE, Dunn L, Swift PS, Wara W (2011) Predictors of the trajectories of self-reported sleep disturbance in men with prostate cancer during and following radiation therapy. Sleep 34(2):171–179CrossRefPubMedPubMedCentral Miaskowski C, Paul SM, Cooper BA, Lee K, Dodd M, West C, Aouizerat BE, Dunn L, Swift PS, Wara W (2011) Predictors of the trajectories of self-reported sleep disturbance in men with prostate cancer during and following radiation therapy. Sleep 34(2):171–179CrossRefPubMedPubMedCentral
17.
go back to reference Spielman AJ, Caruso LS, Glovinsky PB (1987) A behavioral perspective on insomnia treatment. Psychiatr Clin 10(4):541–553 Spielman AJ, Caruso LS, Glovinsky PB (1987) A behavioral perspective on insomnia treatment. Psychiatr Clin 10(4):541–553
18.
go back to reference Fiorentino L, Rissling M, Liu L, Ancoli-Israel S (2011) The symptom cluster of sleep, fatigue and depressive symptoms in breast cancer patients: severity of the problem and treatment options. Drug Discov Today Dis Model 8(4):167–173CrossRef Fiorentino L, Rissling M, Liu L, Ancoli-Israel S (2011) The symptom cluster of sleep, fatigue and depressive symptoms in breast cancer patients: severity of the problem and treatment options. Drug Discov Today Dis Model 8(4):167–173CrossRef
19.
go back to reference Savard J, Morin CM (2001) Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 19(3):895–908CrossRefPubMed Savard J, Morin CM (2001) Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 19(3):895–908CrossRefPubMed
20.
go back to reference Savard J, Villa J, Ivers H, Simard S, Morin CM (2009) Prevalence, natural course, and risk factors of insomnia comorbid with cancer over a 2-month period. J Clin Oncol 27(31):5233–5239CrossRefPubMed Savard J, Villa J, Ivers H, Simard S, Morin CM (2009) Prevalence, natural course, and risk factors of insomnia comorbid with cancer over a 2-month period. J Clin Oncol 27(31):5233–5239CrossRefPubMed
23.
go back to reference LeBlanc M, Merette C, Savard J, Ivers H, Baillargeon L, Morin CM (2009) Incidence and risk factors of insomnia in a population-based sample. Sleep 32(8):1027–1037CrossRefPubMedPubMedCentral LeBlanc M, Merette C, Savard J, Ivers H, Baillargeon L, Morin CM (2009) Incidence and risk factors of insomnia in a population-based sample. Sleep 32(8):1027–1037CrossRefPubMedPubMedCentral
26.
go back to reference Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRefPubMed Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRefPubMed
27.
go back to reference Steentjes L, Siesling S, Drummond FJ, van Manen JG, Sharp L, Gavin A (2016) Factors associated with current and severe physical side-effects after prostate cancer treatment: what men report. Eur J Cancer Care (Engl) 27. https://doi.org/10.1111/ecc.12589 Steentjes L, Siesling S, Drummond FJ, van Manen JG, Sharp L, Gavin A (2016) Factors associated with current and severe physical side-effects after prostate cancer treatment: what men report. Eur J Cancer Care (Engl) 27. https://​doi.​org/​10.​1111/​ecc.​12589
28.
go back to reference van Andel G, Bottomley A, Fossa SD, Efficace F, Coens C, Guerif S, Kynaston H, Gontero P, Thalmann G, Akdas A, D’Haese S, Aaronson NK (2008) An international field study of the EORTC QLQ-PR25: a questionnaire for assessing the health-related quality of life of patients with prostate cancer. Eur J Cancer 44(16):2418–2424. https://doi.org/10.1016/j.ejca.2008.07.030 CrossRefPubMed van Andel G, Bottomley A, Fossa SD, Efficace F, Coens C, Guerif S, Kynaston H, Gontero P, Thalmann G, Akdas A, D’Haese S, Aaronson NK (2008) An international field study of the EORTC QLQ-PR25: a questionnaire for assessing the health-related quality of life of patients with prostate cancer. Eur J Cancer 44(16):2418–2424. https://​doi.​org/​10.​1016/​j.​ejca.​2008.​07.​030 CrossRefPubMed
31.
go back to reference Pickard AS, De Leon MC, Kohlmann T, Cella D, Rosenbloom S (2007) Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Med Care 45:259–263CrossRefPubMed Pickard AS, De Leon MC, Kohlmann T, Cella D, Rosenbloom S (2007) Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Med Care 45:259–263CrossRefPubMed
32.
go back to reference Juul T, Petersen MA, Holzner B, Laurberg S, Christensen P, Grønvold M (2014) Danish population-based reference data for the EORTC QLQ-C30: associations with gender, age and morbidity. Qual Life Res 23(8):2183–2193CrossRefPubMed Juul T, Petersen MA, Holzner B, Laurberg S, Christensen P, Grønvold M (2014) Danish population-based reference data for the EORTC QLQ-C30: associations with gender, age and morbidity. Qual Life Res 23(8):2183–2193CrossRefPubMed
33.
go back to reference Waldmann A, Schubert D, Katalinic A (2013) Normative data of the EORTC QLQ-C30 for the German population: a population-based survey. PLoS One 8(9):e74149CrossRefPubMedPubMedCentral Waldmann A, Schubert D, Katalinic A (2013) Normative data of the EORTC QLQ-C30 for the German population: a population-based survey. PLoS One 8(9):e74149CrossRefPubMedPubMedCentral
34.
go back to reference Li X, Wong W, Lamoureux EL, Wong TY (2012) Are linear regression techniques appropriate for analysis when the dependent (outcome) variable is not normally distributed? Invest Ophthalmol Vis Sci 53(6):3082–3083CrossRefPubMed Li X, Wong W, Lamoureux EL, Wong TY (2012) Are linear regression techniques appropriate for analysis when the dependent (outcome) variable is not normally distributed? Invest Ophthalmol Vis Sci 53(6):3082–3083CrossRefPubMed
35.
go back to reference Scott NW, Fayers P, Aaronson NK, Bottomley A, de Graeff A, Groenvold M, Gundy C, Koller M, Petersen MA, Sprangers MA (2008) EORTC QLQ-C30 reference values manual Scott NW, Fayers P, Aaronson NK, Bottomley A, de Graeff A, Groenvold M, Gundy C, Koller M, Petersen MA, Sprangers MA (2008) EORTC QLQ-C30 reference values manual
36.
go back to reference Drummond FJ, Gavin AT, Sharp L (2017) Supportive medications and interventions received by prostate cancer survivors: results from the PiCTure study. J Community Support Oncol 15(6):e309–e313CrossRef Drummond FJ, Gavin AT, Sharp L (2017) Supportive medications and interventions received by prostate cancer survivors: results from the PiCTure study. J Community Support Oncol 15(6):e309–e313CrossRef
38.
go back to reference Hoyt MA, Bower JE, Irwin MR, Weierich MR, Stanton AL (2016) Sleep quality and depressive symptoms after prostate cancer: the mechanistic role of cortisol. Behav Neurosci 130(3):351–356CrossRefPubMedPubMedCentral Hoyt MA, Bower JE, Irwin MR, Weierich MR, Stanton AL (2016) Sleep quality and depressive symptoms after prostate cancer: the mechanistic role of cortisol. Behav Neurosci 130(3):351–356CrossRefPubMedPubMedCentral
Metadata
Title
Problems sleeping with prostate cancer: exploring possible risk factors for sleep disturbance in a population-based sample of survivors
Authors
Rebecca Maguire
Frances J. Drummond
Paul Hanly
Anna Gavin
Linda Sharp
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 9/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4633-z

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