Sleep disturbance and decrements in morning energy contribute to a higher symptom burden in oncology patients.
Sleep disturbance and decrements in morning energy contribute to a higher symptom burden in oncology patients.
复制标题
睡眠障碍和早晨能量减少会导致肿瘤患者出现更高的症状负担。
DOI：
10.1016/j.sleep.2023.06.004
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发表时间：
2023
期刊：
影响因子：
4.8
通讯作者：
Miaskowski,Christine
中科院分区：
文献类型：
--
作者：
Davis,JasnaKrupalija;Mark,Sueann;Mackin,Lynda;Paul,StevenM;Cooper,BruceA;Conley,YvetteP;Hammer,MarilynJ;Levine,JonD;Miaskowski,Christine
目的/背景一个新兴的研究领域是睡眠障碍和能量下降之间的关系。鉴于缺乏对这两种症状共同发生的研究，研究目的是确定具有不同联合睡眠障碍和早晨能量特征的肿瘤患者亚组，并评估亚组之间在人口统计学、临床和睡眠障碍特征方面的差异，以及其他常见症状的严重程度和QOL结果。（n = 1336）在两个化疗周期内完成了6次睡眠障碍和能量的测量。所有其他测量均在入组时完成。潜谱分析用于识别不同的联合睡眠障碍和早晨能量profiles.ResultsThree不同的配置文件被确定（即，低睡眠障碍和高早晨精力（正常，20.6%），中度睡眠障碍和低早晨精力（中度严重，52.1%），非常高的睡眠障碍和非常低的早晨精力（非常严重，27.3%）。与普通班相比，其他两个班的女性比例更高，就业比例更低，合并症负担更重，功能状况更差。症状评分和QOL结果显示出剂量反应效应（即，随着病情恶化，症状评分增加，QOL评分降低）.Conclusionsgiven睡眠障碍和能量下降之间的关联，以及更高的症状负担，更差的QOL结果和死亡率增加，这两种症状的评估需要成为临床医生和适当干预措施的高度优先事项。
Objective/BackgroundAn emerging area of research is the relationship between sleep disturbance and decrements in energy. Given the paucity of research on the co-occurrence of these two symptoms, study purposes were to identify subgroups of oncology patients with distinct joint sleep disturbance AND morning energy profiles and evaluate for differences among the subgroups in demographic, clinical, and sleep disturbance characteristics, as well as the severity of other common symptoms and QOL outcomes.Patients/methodsPatients (n = 1336) completed measures of sleep disturbance and energy 6 times over two cycles of chemotherapy. All of the other measures were completed at enrollment. Latent profile analysis was used to identify the distinct joint sleep disturbance and morning energy profiles.ResultsThree distinct profiles were identified (i.e., Low Sleep Disturbance and High Morning Energy (Normal, 20.6%), Moderate Sleep Disturbance and Low Morning Energy (Moderately Severe, 52.1%), Very High Sleep Disturbance and Very Low Morning Energy (Very Severe, 27.3%). Compared to Normal class, other two classes were more likely to be female, less likely to be employed, and had higher comorbidity burden and poorer functional status. Symptom scores and QOL outcomes exhibited a dose response effect (i.e., as the profile worsened, symptom scores increased and QOL scores decreased).ConclusionsGiven the associations between sleep disturbance and decrements in energy and a higher symptom burden, poorer QOL outcomes, and increased mortality, assessment of these two symptoms needs to be a high priority for clinicians and appropriate interventions initiated.