Sleep disorders and QOL in lung cancer survivors

肺癌幸存者的睡眠障碍和生活质量

• 批准号: 7689244
• 负责人: Nalaka S Gooneratne
• 金额: $ 19.69万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-16 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7689244
• 关键词: Address; Affect; Area; Breathing; Cancer Control; Cancer Survivor; Cohort Studies; Comorbidity; Data; Data Set; Development; Diagnosis; Disease; Distress; Dyspnea; Early Diagnosis; Etiology; Excision; Exploratory/Developmental Grant; Face; Future; Goals; Hypoxia; Impairment; Individual; Intervention; Intervention Studies; Investigation; Knowledge; Lead; Living Wills; Long-Term Effects; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Measurement; Measures; Melatonin; Methods; Multivariate Analysis; Nocturnal Myoclonus Syndrome; Odds Ratio; Operative Surgical Procedures; Outcome; Outcome Measure; Patient Self-Report; Patients; Performance; Physicians; Polysomnography; Population; Prevalence; Protocols documentation; Psychomotor Performance; Quality of life; Radiation therapy; Relative (related person); Relative Risks; Research; Research Personnel; Risk; Risk Factors; Role; Sample Size; Sampling; Severities; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleeplessness; Smoking History; Survivors; Symptoms; Testing; Time; United States; Visit; age related; base; cancer therapy; clinical care; design; effective therapy; experience; follow-up; functional disability; high risk; improved; interest; longitudinal design; mortality; novel; novel strategies; patient population; public health relevance; pulmonary function; treatment strategy

DESCRIPTION (provided by investigator): Advances in lung cancer treatment have resulted in increased opportunities for long term (>5 year) survival. However, these lung cancer survivors, more so than most other cancer survivors, have significant additional comorbidity as a result of their lung cancer treatment, past smoking history and pre-existing diseases. Sleep disorders, such as insomnia, are especially common. Preliminary investigations have shown that the majority of these lung cancer survivors suffer from insomnia at rates higher than survivors of most other cancers, that this insomnia is associated with significant impairments in quality of life even when controlling for other symptoms such as dyspnea, and that mortality rates may be higher in those with insomnia. This application seeks to extend these findings by conducting a study in 280 long-term lung cancer survivors that incorporates polysomnography and pulmonary function measurements in a longitudinal design with a one-year follow-up reassessment; this is a novel approach in this patient population. The proposed study is thus uniquely designed to test the hypotheses that sleep disorders are common in lung cancer survivors and are associated with significant sequelae. It will address several key specific aims: 1) identify the prevalence of sleep disorders in lung cancer survivors using polysomnography, the only accurate method to identify sleep-related breathing disorders, amongst others; 2) determine the risk factors for insomnia; and 3) determine the longitudinal outcomes of insomnia. In addition to exploring the interaction of comorbid conditions and sleep disorders in lung cancer survivors, the proposed study will also examine the effects of age-related changes in the sleep-wake drive, such as altered melatonin levels. The overall feasibility of this application is enhanced by the access to a large survivor population from an active cardiothoracic surgery practice and the past experience of the research team as demonstrated by their preliminary data. The study is also adequately powered to address several specific hypotheses that are relevant to the clinical care of cancer survivors. Exploratory analyses include comparisons with a pre-existing dataset of 420 older non-cancer subjects to allow for comparison of sleep parameters. An important developmental aspect of the protocol is that the investigators will conduct exploratory multivariate analysis. This will be used to provide more accurate point estimates for sample size calculations for the design of future studies in lung cancer survivors and identify potential areas for future intervention studies. The findings from this study thus have the potential to significantly advance our understanding of the etiology and consequences of sleep disorders in cancer survivors, improve the clinical care they receive, and lay the groundwork for future investigations in this relatively understudied area. PUBLIC HEALTH RELEVANCE: Sleep disorders such as insomnia are common in lung cancer survivors, yet relatively little research has been done in this area and past studies have not included tests to diagnose common sleep disorders such as sleep apnea (abnormal breathing during sleep). The proposed study will use more accurate sleep tests (also known as polysomnographies) and follow patients over time to determine if sleep disorders can lead to increased risks of negative outcomes. This information will help physicians to better understand and treat sleep problems in cancer survivors.

描述（由研究人员提供）：肺癌治疗的进展导致长期（> 5年）生存的机会增加了。然而，这些肺癌幸存者比大多数其他癌症幸存者更重要，由于其肺癌治疗，过去的吸烟史和预先存在的疾病，具有显着的合并症。睡眠障碍（例如失眠症）尤其普遍。初步研究表明，这些肺癌幸存者中的大多数患病率高于大多数其他癌症的幸存者，即使控制其他疾病等其他症状，这种失眠与生活质量的重大障碍有关，并且患有失眠症患者的死亡率可能更高。该应用程序旨在通过对280个长期肺癌幸存者进行一项研究来扩展这些发现，该研究将多个术语和肺功能测量纳入纵向设计中，并进行了为期一年的随访重新评估。这是该患者人群的一种新方法。因此，拟议的研究的独特设计是为了测试肺癌幸存者中睡眠障碍常见的假设，并且与重大后遗症有关。它将针对几个关键的特定目的：1）使用多聚疗法识别肺癌幸存者睡眠障碍的患病率，这是识别与睡眠相关的呼吸障碍等唯一准确的方法； 2）确定失眠的危险因素； 3）确定失眠的纵向结局。除了探索肺癌幸存者中合并症和睡眠障碍的相互作用外，拟议的研究还将检查睡眠效果驱动中与年龄相关的变化的影响，例如改变的褪黑激素水平。通过积极的心胸外科手术实践和研究团队的过去经验，他们的初步数据证明了该应用程序的总体可行性，从而增强了该应用程序的总体可行性。这项研究还充分有助于解决与癌症幸存者临床护理有关的几种特定假设。探索性分析包括与420个较旧的非癌症受试者的预先存在的数据集进行比较，以允许比较睡眠参数。协议的一个重要发展方面是研究人员将进行探索性多元分析。这将用于为样本量计算提供更准确的点估计，以设计未来的肺癌幸存者研究，并确定未来干预研究的潜在领域。因此，这项研究的发现有可能显着提高我们对癌症幸存者睡眠障碍的病因和后果的理解，改善他们接受的临床护理，并为在这个相对研究的领域进行未来研究奠定基础。 公共卫生相关性：肺癌幸存者常见的睡眠障碍，例如失眠症，但在这一领域进行的研究很少，过去的研究尚未包括诊断常见睡眠障碍（如睡眠呼吸暂停）（睡眠异常呼吸）的测试。拟议的研究将使用更准确的睡眠测试（也称为多聚征库），并随着时间的推移关注患者，以确定睡眠障碍是否会导致负面结果的风险增加。这些信息将帮助医生更好地理解和治疗癌症幸存者的睡眠问题。