Top

Sleep and Breathing

Published in:

11-07-2023 | Lung Cancer | Psychiatrics • Original Article

Longitudinal patterns of patient-reported sleep disturbances after surgery for lung cancer

Authors: Yang Pu, Wei Xu, Wei Dai, Xing Wei, Hongfan Yu, Qingsong Yu, Xueyao Su, Ruoyan Gong, Yubo Zhang, Qiuling Shi

Published in: Sleep and Breathing | Issue 1/2024

Abstract

Purpose

The purpose of this study was to identify longitudinal heterogeneous trajectories of sleep status, adjusted for the effect of pain over time, among patients who had surgery for lung cancer and to quantify how disturbed sleep in the hospital affects functional recovery after discharge.

Methods

We included patients from a surgical cohort (CN-PRO-Lung 1). All patients reported symptoms using the MD Anderson Symptom Inventory-Lung Cancer (MDASI-LC) daily during postoperative hospitalization. Group-based dual trajectory modeling was used to investigate trajectories of disturbed sleep and pain during the first 7 days of postoperative hospitalization. Cox regression was used to compare the recovery of walking ability between the different sleep trajectories.

Results

Among 421 patients, disturbed sleep trajectories comprised low (31%), moderate (52%), and high (17%) groups. The surgical approach and number of chest tubes were associated with pain, and the number of chest tubes was also associated with sleep disturbances (OR = 1.99; 95% CI: 1.08–3.67). Recovery of walking ability after discharge was significantly slower in the high (median days = 16; 95% CI: 5-NA) and moderate disturbed sleep trajectory groups (median days = 5; 95%CI: 4–6) than in the low group (median days = 3; 95% CI: 3–4).

Conclusion

Changes in disturbed sleep among patients with lung cancer followed three distinct trajectories over the first 7 days of hospitalization after surgery. Dual trajectory analyses highlighted the high concordance between specific trajectories of disturbed sleep and pain. Patients at high sleep disturbance and high levels of pain may benefit from appropriate interventions for both symptoms in combination with the patient’s surgical approach and the number of chest tubes.

Available only for authorised users

Fagundes CP, Shi Q, Vaporciyan AA, Rice DC, Popat KU, Cleeland CS et al (2015) Symptom recovery after thoracic surgery: measuring patient-reported outcomes with the MD Anderson Symptom Inventory. J Thorac Cardiovasc Surg 150(3):613–9.e2. https://doi.org/10.1016/j.jtcvs.2015.05.057CrossRefPubMedPubMedCentral

Lin S, Chen Y, Yang L, Zhou J (2013) Pain, fatigue, disturbed sleep and distress comprised a symptom cluster that related to quality of life and functional status of lung cancer surgery patients. J Clin Nurs 22(9–10):1281–1290. https://doi.org/10.1111/jocn.12228CrossRefPubMed

Fernandes NM, Nield LE, Popel N, Cantor WJ, Plante S, Goldman L et al (2014) Symptoms of disturbed sleep predict major adverse cardiac events after percutaneous coronary intervention. Can J Cardiol 30(1):118–124. https://doi.org/10.1016/j.cjca.2013.07.009CrossRefPubMed

Westerlund A, Bellocco R, Sundstrom J, Adami HO, Akerstedt T, Trolle Lagerros Y (2013) Sleep characteristics and cardiovascular events in a large Swedish cohort. Eur J Epidemiol 28(6):463–473. https://doi.org/10.1007/s10654-013-9802-2CrossRefPubMed

Chan MTV, Wang CY, Seet E, Tam S, Lai HY, Chew EFF et al (2019) Association of unrecognized obstructive sleep apnea with postoperative cardiovascular events in patients undergoing major noncardiac surgery. JAMA 321(18):1788–1798. https://doi.org/10.1001/jama.2019.4783CrossRefPubMedPubMedCentral

Liu L, Rissling M, Natarajan L, Fiorentino L, Mills PJ, Dimsdale JE et al (2012) The longitudinal relationship between fatigue and sleep in breast cancer patients undergoing chemotherapy. Sleep 35(2):237–245. https://doi.org/10.5665/sleep.1630CrossRefPubMedPubMedCentral

Prather AA, Leung CW (2016) Association of insufficient sleep with respiratory infection among adults in the United States. JAMA Intern Med 176(6):850–852. https://doi.org/10.1001/jamainternmed.2016.0787CrossRefPubMedPubMedCentral

Roberts RE, Duong HT (2014) The prospective association between sleep deprivation and depression among adolescents. Sleep 37(2):239–244. https://doi.org/10.5665/sleep.3388CrossRefPubMedPubMedCentral

Szentkiralyi A, Madarasz CZ, Novak M (2009) Sleep disorders: impact on daytime functioning and quality of life. Expert Rev Pharmacoecon Outcomes Res 9(1):49–64. https://doi.org/10.1586/14737167.9.1.49CrossRefPubMed

10.

Luo ZY, Li LL, Wang D, Wang HY, Pei FX, Zhou ZK (2019) Preoperative sleep quality affects postoperative pain and function after total joint arthroplasty: a prospective cohort study. J Orthop Surg Res 14(1):378. https://doi.org/10.1186/s13018-019-1446-9CrossRefPubMedPubMedCentral

11.

Bixler E (2009) Sleep and society: an epidemiological perspective. Sleep Med 10(Suppl 1):S3-6. https://doi.org/10.1016/j.sleep.2009.07.005CrossRefPubMed

12.

Shi Q, Mendoza TR, Gunn GB, Wang XS, Rosenthal DI, Cleeland CS (2013) Using group-based trajectory modeling to examine heterogeneity of symptom burden in patients with head and neck cancer undergoing aggressive non-surgical therapy. Qual Life Res 22(9):2331–2339. https://doi.org/10.1007/s11136-013-0380-2CrossRefPubMed

13.

Sharma SK, Thakur K, Mudgal SK, Payal YS (2020) Acute postoperative pain experiences and satisfaction with its management among patients with elective surgery: an observational study. Indian J Anaesth 64(5):403–408. https://doi.org/10.4103/ija.IJA_33_20CrossRefPubMedPubMedCentral

14.

Wesselius HM, van den Ende ES, Alsma J, Ter Maaten JC, Schuit SCE, Stassen PM et al (2018) Quality and quantity of sleep and factors associated with sleep disturbance in hospitalized patients. JAMA Intern Med 178(9):1201–1208. https://doi.org/10.1001/jamainternmed.2018.2669CrossRefPubMedPubMedCentral

15.

Aparicio C, Panin F (2020) Interventions to improve inpatients’ sleep quality in intensive care units and acute wards: a literature review. Br J Nurs 29(13):770–6. https://doi.org/10.12968/bjon.2020.29.13.770CrossRefPubMed

16.

Nagin DS (2005) Group-based modeling of development. Harvard University PressCrossRef

17.

Nagin DS, Odgers CL (2010) Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol 6:109–138. https://doi.org/10.1146/annurev.clinpsy.121208.131413CrossRefPubMed

18.

Vasilopoulos T, Wardhan R, Rashidi P, Fillingim RB, Wallace MR, Crispen PL et al (2021) Patient and procedural determinants of postoperative pain trajectories. Anesthesiology 134(3):421–434. https://doi.org/10.1097/ALN.0000000000003681CrossRefPubMed

19.

Di Meglio A, Havas J, Gbenou AS, Martin E, El-Mouhebb M, Pistilli B et al (2022) Dynamics of long-term patient-reported quality of life and health behaviors after adjuvant breast cancer chemotherapy. J Clin Oncol 40(27):3190–3204. https://doi.org/10.1200/JCO.21.00277CrossRefPubMedPubMedCentral

20.

Vaz-Luis I, Di Meglio A, Havas J, El-Mouhebb M, Lapidari P, Presti D et al (2022) Long-term longitudinal patterns of patient-reported fatigue after breast cancer: a group-based trajectory analysis. J Clin Oncol 40(19):2148–2162. https://doi.org/10.1200/JCO.21.01958CrossRefPubMedPubMedCentral

21.

Yu Q, Yu H, Xu W, Pu Y, Nie Y, Dai W et al (2022) Shortness of breath on day 1 after surgery alerting the presence of early respiratory complications after surgery in lung cancer patients. Patient Prefer Adherence 16:709–722. https://doi.org/10.2147/PPA.S348633CrossRefPubMedPubMedCentral

22.

Tran Y, Tang D, Lo C, McMahon C, Mitchell P, Gopinath B (2021) Co-occurring hearing loss and cognitive decline in older adults: a dual group-based trajectory modeling approach. Front Aging Neurosci 13:794787. https://doi.org/10.3389/fnagi.2021.794787CrossRefPubMedPubMedCentral

23.

Xiang X, Lai PHL, Bao L, Sun Y, Chen J, Dunkle RE et al (2021) Dual trajectories of social isolation and dementia in older adults: a population-based longitudinal study. J Aging Health 33(1–2):63–74. https://doi.org/10.1177/0898264320953693CrossRefPubMed

24.

Chang LY, Chang HY, Wu WC, Lin LN, Wu CC, Yen LL (2018) Dual trajectories of sleep duration and cigarette smoking during adolescence: relation to subsequent internalizing problems. J Abnorm Child Psychol 46(8):1651–1663. https://doi.org/10.1007/s10802-018-0414-xCrossRefPubMed

25.

Liu I, Huang YJ, Wang LK, Tsai YH, Hsu SL, Chang CJ et al (2021) Dual trajectories of loneliness and depression and their baseline correlates over a 14-year follow-up period in older adults: results from a nationally representative sample in Taiwan. Int J Older People Nurs 16(6):e12410. https://doi.org/10.1111/opn.12410CrossRefPubMed

26.

Song J, Lee J, Lee YC, Chang AH, Semanik PA, Chang RW et al (2021) Sleep disturbance trajectories in osteoarthritis. J Clin Rheumatol 27(8):e440–e445. https://doi.org/10.1097/RHU.0000000000001512CrossRefPubMedPubMedCentral

27.

Tejada M, Viele C, Kober KM, Cooper BA, Paul SM, Dunn LB et al (2019) Identification of subgroups of chemotherapy patients with distinct sleep disturbance profiles and associated co-occurring symptoms. Sleep 42(10). https://doi.org/10.1093/sleep/zsz151

28.

Peristera P, Nyberg A, Magnusson Hanson LL, Westerlund H, Platts LG (2022) How consistently does sleep quality improve at retirement? Prospective analyses with group-based trajectory models. J Sleep Res 31(2):e13474. https://doi.org/10.1111/jsr.13474CrossRefPubMed

29.

Dai W, Xie S, Zhang R, Wei X, Wu C, Zhang Y et al (2019) Developing and validating utility parameters to establish patient-reported outcome-based perioperative symptom management in patients with lung cancer: a multicentre, prospective, observational cohort study protocol. BMJ Open 9(10):e030726. https://doi.org/10.1136/bmjopen-2019-030726CrossRefPubMedPubMedCentral

30.

Wei X, Yu H, Dai W, Mu Y, Wang Y, Liao J et al (2021) Patient-reported outcomes of video-assisted thoracoscopic surgery versus thoracotomy for locally advanced lung cancer: a longitudinal cohort study. Ann Surg Oncol 28(13):8358–8371. https://doi.org/10.1245/s10434-021-09981-1CrossRefPubMed

31.

Mendoza TR, Wang XS, Lu C, Palos GR, Liao Z, Mobley GM et al (2011) Measuring the symptom burden of lung cancer: the validity and utility of the lung cancer module of the M D Anderson Symptom Inventory. Oncologist 16(2):217–227. https://doi.org/10.1634/theoncologist.2010-0193CrossRefPubMedPubMedCentral

32.

Shi Q, Wang XS, Vaporciyan AA, Rice DC, Popat KU, Cleeland CS (2016) Patient-reported symptom interference as a measure of postsurgery functional recovery in lung cancer. J Pain Symptom Manage 52(6):822–831. https://doi.org/10.1016/j.jpainsymman.2016.07.005CrossRefPubMedPubMedCentral

33.

Dai W, Feng W, Zhang Y, Wang XS, Liu Y, Pompili C et al (2022) Patient-reported outcome-based symptom management versus usual care after lung cancer surgery: a multicenter randomized controlled trial. J Clin Oncol 40(9):988–996. https://doi.org/10.1200/JCO.21.01344CrossRefPubMedPubMedCentral

34.

Denlinger CS, Ligibel JA, Are M, Baker KS, Demark-Wahnefried W, Friedman DL et al (2014) Survivorship: sleep disorders, version 1.2014. J Natl Compr Canc Netw 12(5):630–42. https://doi.org/10.6004/jnccn.2014.0067CrossRefPubMedPubMedCentral

35.

Lavigne GJ, Sessle BJ (2016) The neurobiology of orofacial pain and sleep and their interactions. J Dent Res 95(10):1109–1116. https://doi.org/10.1177/0022034516648264CrossRefPubMed

36.

Sit RWS, Yip BHK, Wang B, Chan DCC, Zhang D, Wong SYS (2021) Chronic musculoskeletal pain prospectively predicts insomnia in older people, not moderated by age, gender or co-morbid illnesses. Sci Rep 11(1):1593. https://doi.org/10.1038/s41598-021-81390-6ADSCrossRefPubMedPubMedCentral

37.

Bendixen M, Jorgensen OD, Kronborg C, Andersen C, Licht PB (2016) Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. Lancet Oncol 17(6):836–844. https://doi.org/10.1016/S1470-2045(16)00173-XCrossRefPubMed

38.

Liao J, Wang Y, Dai W, Wei X, Yu H, Yang P et al (2022) Profiling symptom burden and its influencing factors at discharge for patients undergoing lung cancer surgery: a cross-sectional analysis. J Cardiothorac Surg 17(1):229. https://doi.org/10.1186/s13019-022-01974-9CrossRefPubMedPubMedCentral

39.

Zhou D, Deng XF, Liu QX, Chen Q, Min JX, Dai JG (2016) Single chest tube drainage is superior to double chest tube drainage after lobectomy: a meta-analysis. J Cardiothorac Surg 11(1):88. https://doi.org/10.1186/s13019-016-0484-1CrossRefPubMedPubMedCentral

40.

Zhang X, Lv D, Li M, Sun G, Liu C (2016) The single chest tube versus double chest tube application after pulmonary lobectomy: a systematic review and meta-analysis. J Cancer Res Ther 12(Supplement):C309–C316. https://doi.org/10.4103/0973-1482.200743CrossRefPubMed

41.

Bower JE, Bak K, Berger A, Breitbart W, Escalante CP, Ganz PA et al (2014) Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation. J Clin Oncol 32(17):1840–1850. https://doi.org/10.1200/JCO.2013.53.4495CrossRefPubMedPubMedCentral

42.

Ali Ismail AM (2022) Virtual-reality rehabilitation for inpatient elderly leukemic patients: psychological and physical roles during the fourth COVID-19 wave. Fam Med Prim Care Rev 24(2):185–186. https://doi.org/10.5114/fmpcr.2022.115882CrossRef

43.

Ismail AMA (2021) rehabilitation with virtual reality for leukemic children during the fourth COVID-19 wave. Integr Cancer Ther 20:15347354211049340. https://doi.org/10.1177/15347354211049341CrossRefPubMedPubMedCentral

44.

Nagin DS, Jones BL, Passos VL, Tremblay RE (2018) Group-based multi-trajectory modeling. Stat Methods Med Res 27(7):2015–2023. https://doi.org/10.1177/0962280216673085MathSciNetCrossRefPubMed

Title: Longitudinal patterns of patient-reported sleep disturbances after surgery for lung cancer
Authors: Yang Pu
Wei Xu
Wei Dai
Xing Wei
Hongfan Yu
Qingsong Yu
Xueyao Su
Ruoyan Gong
Yubo Zhang
Qiuling Shi
Publication date: 11-07-2023
Publisher: Springer International Publishing
Keywords: Lung Cancer
Lung Cancer
Lung Cancer
Published in: Sleep and Breathing / Issue 1/2024
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-023-02877-2

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2024

Diurnal variation in variables related to cognitive performance: a systematic review

Polysomnographic findings in children with 22q deletion & duplication syndrome: relationship to genetic diagnosis, parent-reported symptoms, and calcium levels

Rotating shift work time is directly associated with excess body adiposity

Cerebellar volumes and the intrinsic cerebellar network in patients with obstructive sleep apnea

Is there an OAHI or O2 nadir that predicts the need for preoperative echocardiogram prior to adenotonsillectomy for children with severe obstructive sleep apnea?

A comparison of nocturnal upper trapezius muscle activity between chronic neck pain patients with sleep disturbance and healthy participants

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials