Sleepless from the Get Go: Sleep Problems Prior to Initiating Cancer Treatment
Sleepless from the Get Go: Sleep Problems Prior to Initiating Cancer Treatment
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DOI：
10.1007/s12529-018-9715-2
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发表时间：
2018-10-01
影响因子：
2.7
通讯作者：
Loscalzo, Matthew
中科院分区：
文献类型：
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作者：
Zhou, Eric S.;Clark, Karen;Loscalzo, Matthew
癌症患者可能会遇到睡眠问题。了解他们对睡眠问题的看法很重要，因为主观症状体验与寻求治疗的行为有关。我们探讨了一个大样本的癌症患者在一个重要的，但未充分研究的阶段，他们的癌症旅程的患病率及其相关性：在开始treatment.MethodsCancer患者（5702）（67.5%女性; 76.9%白色; 23.0%西班牙裔），诊断后，开始癌症治疗之前，完成了电子筛查仪器。八种不同癌症诊断（乳腺癌、胃肠道癌、妇科癌、头颈癌、血液癌、肺癌、前列腺癌、泌尿系癌）的患者对他们的睡眠问题进行了五分制评分，报告严重或非常严重睡眠问题的患者被归类为患有严重睡眠问题。结果总体而言，12.5%的患者报告了严重的睡眠问题。在诊断中，报告高睡眠问题的患者比例从4.3%到13.8%不等，前列腺癌患者最不可能报告高睡眠问题，胃肠道癌患者最有可能报告高睡眠问题。年龄较大，有伴侣，受过高等教育和家庭收入较高与经历睡眠问题的可能性较低有关。作为女性，黑人，西班牙裔，并报告焦虑或抑郁症与增加的可能性睡眠problems.ConclusionsA相当大比例的癌症患者的经验显着的问题，他们的睡眠之前，任何治疗已经发生。这个临床问题不能忽视，因为治疗可能会恶化现有的睡眠问题。肿瘤提供者应定期筛查睡眠相关问题。识别和治疗癌症早期脆弱时期的睡眠问题应该是临床护理的重要组成部分。
PurposeCancer patients are likely to experience sleep problems. Understanding their perception of sleep problems is important as subjective symptom experience is associated with treatment-seeking behavior. We explored the prevalence of sleep problems and its correlates in a large sample of cancer patients at an important but understudied stage of their cancer journey: prior to initiating treatment.MethodsCancer patients (5702) (67.5% female; 76.9% White; 23.0% Hispanic), following diagnosis and prior to initiating cancer treatment, completed an electronic screening instrument. Patients across eight different cancer diagnoses (breast, gastrointestinal, gynecological, head and neck, hematological, lung, prostate, urinary) rated their sleep problems on a five-point scale, with those reporting severe or very severe sleep problems classified as having high sleep problems.ResultsOverall, 12.5% of patients reported high sleep problems. Across diagnoses, the proportion of patients reporting high sleep problems ranged from 4.3 to 13.8%, with prostate cancer patients least likely and gastrointestinal cancer patients most likely to report high sleep problems. Older age, having a partner, higher education, and higher household income were associated with a lower likelihood of experiencing sleep problems. Being female, Black, Hispanic, and reporting anxiety or depression was associated with an increased likelihood of sleep problems.ConclusionsA sizeable proportion of cancer patients experience significant problems with their sleep before any treatment has occurred. This clinical issue cannot be ignored as treatment is likely to worsen existing sleep problems. Oncology providers should routinely screen for sleep-related problems. Identifying and treating patients for sleep problems during a vulnerable period early in their cancer trajectory should be an essential component of clinical care.