Prevalence, Demographics, and Psychological Associations of Sleep Disruption in Patients With Cancer: University of Rochester Cancer Center-Community Clinical Oncology Program
Prevalence, Demographics, and Psychological Associations of Sleep Disruption in Patients With Cancer: University of Rochester Cancer Center-Community Clinical Oncology Program
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DOI：
10.1200/jco.2009.22.5011
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发表时间：
2010-01-10
影响因子：
45.3
通讯作者：
Morrow, Gary R.
中科院分区：
文献类型：
--
作者：
Palesh, Oxana G.;Roscoe, Joseph A.;Morrow, Gary R.
研究目的：睡眠障碍在癌症患者和幸存者中普遍存在，但失眠（一种令人痛苦的睡眠障碍）在这些人群中的患病率尚未在大规模研究中确定。（平均年龄58岁; 597名女性患者）在一项前瞻性研究中报告了睡眠困难。36.6%（n = 301）的癌症患者报告了失眠症状，43%（n = 362）符合失眠综合征的诊断标准。年龄小于58岁的癌症患者更容易出现失眠症状或失眠综合征（chi（2）= 13.6; P = .0002）。乳腺癌患者的失眠投诉总数最多。化疗第1周期和第2周期的失眠症状之间存在显著正相关（phi = 0.62，P <0.0001），表明化疗前两个周期的失眠持续存在。60%的患者样本报告说，他们的失眠症状从第1周期到第2周期保持不变。那些失眠的投诉有显着更多的抑郁和疲劳比良好的睡眠者（所有P < .0001）。ConclusionThe比例的癌症患者在这个样本中报告的失眠症状和满足诊断标准的失眠综合征化疗期间约3倍高于在一般人群中报告的比例。对于本研究中的大多数癌症患者，在整个第二个化疗周期内持续存在不适主诉。在接受化疗的癌症患者中，胰岛素抵抗普遍存在，认识不足，管理不足，研究不足。
PurposeSleep disruption is prevalent in patients with cancer and survivors, but the prevalence of insomnia, a distressing sleep disorder, in these populations has yet to be determined in large-scale studies.Patients and MethodsA total of 823 patients with cancer receiving chemotherapy (mean age, 58 years; 597 female patients) reported on sleep difficulties in a prospective study.ResultsDuring day 7 of cycle 1 of chemotherapy, 36.6% (n = 301) of the patients with cancer reported insomnia symptoms, and 43% (n = 362) met the diagnostic criteria for insomnia syndrome. Patients with cancer younger than 58 years were significantly more likely to experience either symptoms of insomnia or insomnia syndrome (chi(2) = 13.6; P = .0002). Patients with breast cancer had the highest number of overall insomnia complaints. A significant positive association was found between symptoms of insomnia during cycles 1 and 2 of chemotherapy (phi = .62, P < .0001), showing persistence of insomnia during the first two cycles of chemotherapy. Sixty percent of the patient sample reported that their insomnia symptoms remained unchanged from cycle 1 to cycle 2. Those with insomnia complaints had significantly more depression and fatigue than good sleepers (all P < .0001).ConclusionThe proportions of patients with cancer in this sample reporting symptoms of insomnia and meeting diagnostic criteria for insomnia syndrome during chemotherapy are approximately three times higher than the proportions reported in the general population. Insomnia complaints persist throughout the second chemotherapy cycle for the majority of patients with cancer in this study. Insomnia is prevalent, underrecognized, undermanaged, and understudied among patients with cancer receiving chemotherapy.