Patients attitudes towards sleep disturbances during chemotherapy.

Sleep disturbances are among the most distressing symptoms in cancer: they often co-occur with fatigue, pain and psychological distress. Despite the negative impact on quality of life, patients rarely seek help for managing their sleep disturbances. This paper presents the results of a multicentre observational study on patients' attitudes towards their sleep problems. The study also investigates symptom correlates. Patients responded to a semi-structured interview and completed the following questionnaires: Pittsburgh Sleep Quality Index; Brief Fatigue Inventory; Hospital Anxiety and Depression Scale; and European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life QLQ-C30 Questionnaire (QLQ-C30). Four hundred and three cancer patients were enrolled in the study. Bad sleepers constituted 66% of the sample. Thirty-eight per cent of them had not turned to any professional to solve their sleep disturbances because they had various beliefs about the importance of the problem and the possibility to be treated. The main correlates of sleep disturbances were psychological distress, reduced physical functioning and reduced overall quality of life. In conclusion, there is a need to sensitise patients to actively search for a solution to their sleep disturbances so they can be solved along with other co-occurring symptoms. Doctors could also be encouraged to dedicate more attention to routinely asking cancer patients about eventual sleep disturbances.

[1]  Paolo Maria Rossini,et al.  Validity of the Italian Version of the Pittsburgh Sleep Quality Index (PSQI) , 2013, Neurological Sciences.

[2]  C. Espie,et al.  Sleep problems in cancer patients: prevalence and association with distress and pain , 2012, Psycho-oncology.

[3]  P. Butow,et al.  Prevalence and predictors of sleep difficulty in a national cohort of women with primary breast cancer three to four months postsurgery. , 2011, Journal of pain and symptom management.

[4]  Aatif M Husain,et al.  Sleep–wake functioning along the cancer continuum: focus group results from the Patient‐Reported Outcomes Measurement Information System (PROMIS®) , 2010, Psycho-oncology.

[5]  Caroline E. Wright,et al.  Psychological Factors Associated with Poor Sleep Prior to Breast Surgery: An Exploratory Study , 2010, Behavioral medicine.

[6]  C. Lombardo,et al.  Sleep and emotions: a focus on insomnia. , 2010, Sleep medicine reviews.

[7]  D. Walsh,et al.  Review: Symptom clusters: myth or reality? , 2010, Palliative medicine.

[8]  J. Dyas,et al.  Patients' and clinicians' experiences of consultations in primary care for sleep problems and insomnia: a focus group study. , 2010, The British journal of general practice : the journal of the Royal College of General Practitioners.

[9]  A. Berger Update on the state of the science: sleep-wake disturbances in adult patients with cancer. , 2009, Oncology nursing forum.

[10]  E. Stepanski,et al.  The relation of trouble sleeping, depressed mood, pain, and fatigue in patients with cancer. , 2009, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[11]  S. Singer,et al.  Quality of care and emotional support from the inpatient cancer patient’s perspective , 2009, Langenbeck's Archives of Surgery.

[12]  M. Sateia,et al.  Clinical guideline for the evaluation and management of chronic insomnia in adults. , 2008, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[13]  K. Bandeen-Roche,et al.  Predictors of Patterns of Pain, Fatigue, and Insomnia During the First Year After a Cancer Diagnosis in the Elderly , 2008, Cancer nursing.

[14]  A. Sorscher How is Your Sleep: A Neglected Topic for Health Care Screening , 2008, The Journal of the American Board of Family Medicine.

[15]  E. Keogh,et al.  Anxiety sensitivity and pain: Generalisability across noxious stimuli , 2008, Pain.

[16]  D. Feldman-Stewart,et al.  How to provide insomnia interventions to people with cancer: insights from patients , 2007, Psycho-oncology.

[17]  T. Furukawa,et al.  Associated and predictive factors of sleep disturbance in advanced cancer patients , 2007, Psycho-oncology.

[18]  N. Meslier,et al.  Sleep disturbances and impaired daytime functioning in outpatients with newly diagnosed lung cancer. , 2007, Lung cancer.

[19]  R. Lam Sleep disturbances and depression: a challenge for antidepressants , 2006, International clinical psychopharmacology.

[20]  P. Conrad The Shifting Engines of Medicalization∗ , 2005 .

[21]  K. Morgan,et al.  Psychological treatment for insomnia in the management of long-term hypnotic drug use: a pragmatic randomised controlled trial. , 2003, The British journal of general practice : the journal of the Royal College of General Practitioners.

[22]  David Cella,et al.  Item banking to improve, shorten and computerize self-reported fatigue: An illustration of steps to create a core item bank from the FACIT-Fatigue Scale , 2003, Quality of Life Research.

[23]  S. Ancoli-Israel,et al.  The relationship between fatigue and sleep in cancer patients: a review. , 2001, European journal of cancer care.

[24]  A. Vigano,et al.  Multidisciplinary symptom control clinic in a cancer center: a retrospective study , 2001, Supportive Care in Cancer.

[25]  C. Cleeland,et al.  Assessing symptom distress in cancer patients , 2000 .

[26]  M. Stefanek,et al.  Sleep alterations in cancer patients. , 1999, Cancer nursing.

[27]  D. Cella,et al.  Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. , 1997, Journal of pain and symptom management.

[28]  S. Grond,et al.  Prevalence and pattern of symptoms in patients with cancer pain: a prospective evaluation of 1635 cancer patients referred to a pain clinic. , 1994, Journal of pain and symptom management.

[29]  G. I. Ringdal,et al.  Testing the EORTC Quality of Life Questionnaire on cancer patients with heterogeneous diagnoses , 1993, Quality of Life Research.

[30]  D. Razavi,et al.  Screening for Adjustment Disorders and Major Depressive Disorders in Cancer In-Patients , 1990, British Journal of Psychiatry.

[31]  Daniel J Buysse,et al.  The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research , 1989, Psychiatry Research.

[32]  R. Snaith,et al.  The Hospital Anxiety And Depression Scale , 2003, Health and quality of life outcomes.

[33]  L. Derogatis,et al.  The prevalence of psychiatric disorders among cancer patients. , 1983, JAMA.

[34]  E. McFadden,et al.  Toxicity and response criteria of the Eastern Cooperative Oncology Group , 1982, American journal of clinical oncology.

[35]  R. Yeung,et al.  Impact of mood disturbance, sleep disturbance, fatigue and pain among patients receiving cancer therapy. , 2013, European journal of cancer care.

[36]  T. Furukawa,et al.  Screening for depression in terminally ill cancer patients in Japan. , 2006, Journal of pain and symptom management.