Sleep Quality of Cancer Patients Receiving Systemic Treatment: A Cross-Sectional Study
Received Date : 16 Oct 2019
Accepted Date : 14 Feb 2020
Available Online : 17 Apr 2020
Doi: 10.37047/jos.2019-71898 - Article's Language: EN
J Oncol Sci. 2020;6(1):15-22
This is an open access article under the CC BY-NC-ND license
Objective: The present research was designed with the aim to detect insomnia in cancer patients and to determine the factors responsible for the development of insomnia through patient information and to provide suggestions for any contribution. Material and Methods: The cross-sectional study was conducted on 264 patients including 132 females and 132 males who attended the Outpatient Therapy Unit of Medical Oncology Department of Medical Faculty Hospital within Ankara University and accepted to take part in the research. The questionnaire prepared by the researchers was implemented through personal interview technique and information was collected from the patient files. The questionnaire form includes demographic information, Pittsburgh Sleep Quality Index (PSQI), and Beck's Depression Inventory. Results: Higher prevalence of insomnia was detected in cancer patients (54.4%). Depression negatively affects the sleep quality and the problem of insomnia in the patients, who were diagnosed with depression before, was remarkable. Furthermore, the female participants were more prone to develop insomnia and depression (61.36%, 25.76%, respectively). The sleep duration was found to be affected positively in patients receiving cisplatin containing regimens (p=0.029) whereas those receiving other platin group drugs were affected negatively (p=0.017). The use of pyrimidine and folic acid group drugs positively affected sleep quality (p=0.031). Conclusion: It can be said that sleeping and mental problems of the patients visiting the oncology clinics should be monitored and cared closely.
  1. (on 18 September 2017). [Crossref] 
  2. Karadağ M. Classification of sleep disorders. Turkiye Klinikleri Arch Lung. 2007;8(3):88-91.
  3. Bingöl N. Hemşirelerin Uyku Kalitesi, İş Doyumu Düzeyleri Arasındaki İlişkinin İncelenmesi. Yüksek Lisans Tezi. Cumhuriyet Üniversitesi; 2006.
  4. Fadıloğlu Ç, İlkbay Y, Yıldırım Y. Sleep quality among nursing home residents. Turkish Journal of Geriatrics. 2006;9(3):165-169.
  5. Kripke DF, Garfinkel L, Wingard DL Klauber MR, Marler MR. Mortality associated with sleep duration and insomnia. Arch Gen Psychiatry. 2002;59(2):131-136. [Crossref]  [PubMed] 
  6. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. [Crossref] 
  7. Bastien CH, Vallières A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001;2(4):297-307. [Crossref] 
  8. Beck SL, Schwartz AL, Towsley G, Dudley W, Barsevick A. Psychometric evaluation of the Pittsburgh Sleep Quality Index in cancer patients. J Pain Symptom Manage. 2004;27(2): 140-148. [Crossref]  [PubMed] 
  9. Koban M, Swinson KL. Chronic REM-sleep deprivation of rats elevates metabolic rate and increases ucp1 gene expression in brown adipose tissue. Am J Physiol Endocrinol Metab. 2005;289(1):68-74. [Crossref]  [PubMed] 
  10. Türk Toraks Derneği. Türk Toraks Derneği Obstrüktif Uyku Apne Sendromu Tanı ve Tedavi Uzlaşı Raporu. Polisomnografi dışı tanı yöntemleri. İstanbul: ADA Ofset Matbaacılık Tic Ltd Şti; 2012;30-32.
  11. Güzel S, Kurtcebe ZÖ, Şencan S, Turhan N. Hormonal influences on the severity of restless legs syndrome, sleep and health-related quality of life in women of reproductive age. Turk J Phys Med Rehab. 2013;59(1):45-51.
  12. Tamakoshi A, Ohno Y. Self-reported sleep duration as a predictor of allcause mortality: results from the JACC study, Japan. Sleep. 2004;27(1):51-54.
  13. Roscoe JA, Kaufman ME, Matteson-Rusby SE, et al. Cancer-related fatigue and sleep disorders. Oncologist. 2007;12(1):35-42. [Crossref]  [PubMed] 
  14. Ağargün MY, Kara H, Anlar O. The validity and reliability of the Pittsburgh sleep quality index. Turk Psikiyatri Derg. 1996;7(2):107-111.
  15. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. Jun 1961;(4): 561-571. [Crossref]  [PubMed] 
  16. Kılınc S, Torun F. Depression rating scales used in clinical practice in Turkey. Dirim Medical Journal. 2011;86(1):39-47.
  17. Guy W. Clinical Global Impressions: ECDEU Assessment Manual for Pharmacology. Revised edition. Rockville, MD: National Institute of Mental Health, Dept of Health, Education and Welfare Publication (ADM); 1976:218-222.
  18. Tegin B. Depresyonda bilişsel bozukluklar: Beck modeline göre bir inceleme. Yayımlanmamış doktora tezi. Ankara: Hacettepe Üniversitesi Sosyal Bilimler Enstitüsü; 1980.
  19. Hisli N. Beck Depresyon Envanteri'nin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi. 1989;23(7):8-13.
  20. Sanlier N, Ayhan B, Ayyıldız F. The scales frequently used and have validity-reliability in field of nutrition and dietetics. International Peer-Reviewed Journal of Nutrition Research. 2015;5(5):47-68. [Crossref] 
  21. Hisli N. Beck Depresyon Envanteri'nin geçerliliği üzerine bir çalışma. Türk Psikoloji Dergisi. 1988;22(6):118-126.
  22. Nazik E, Öztunç G, Şahin B. Effects of progressive relaxation training on sleep quality and pain in patients with breast cancer undergoing chemotherapy. Journal of Anatolia Nursing and Health Sciences. 2014;17(3):171-178.
  23. Savard J, Morin CM. Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol. 2001;19(3):895-908. [Crossref]  [PubMed] 
  24. Davidson JR, MacLean AW, Brundage MD, Schulze K. Sleep disturbance in cancer patients. Soc Sci Med. 2002;54(9):1309-1321. [Crossref] 
  25. Savard J, Simard S, Hervouet D, Ivers H, Lacombe L, Fradet Y. Insomnia in men treated with radical prostatectomy for prostate cancer. Psychooncology. 2005;14(2):147-156. [Crossref]  [PubMed] 
  26. Sateia MJ, Doghramji K, Hauri PJ, Morin CM. Evaluation of chronic insomnia. An American Academy of Sleep Medicine review. Sleep. 2000;23(2):243-308. [Crossref] 
  27. Malone M, Harris AL, Luscombe DK. Assessment of the impact of cancer on work, recreation, home management and sleep using a general health status measure. J R Soc Med. 1994;87(7):386-389.
  28. Mercadante S, Adile C, Ferrera P, Masedu F, Valenti M, Aielli F. Sleep disturbances in advanced cancer patients admitted to a supportive/palliative care unit. Support Care Cancer. 2017;25(4):1301-1306. [Crossref]  [PubMed] 
  29. Köktürk O. Obstrüktif uyku apne sendromu epidemiyolojisi. Tüberküloz ve Toraks Dergisi. 1998;46(2):193-201.
  30. Pack AI. Advances in sleep-disordered breathing. Am J Respir Crit Care Med. 2006;173(1): 7-15. [Crossref]  [PubMed] 
  31. Stradling R, Davies RJO. Obstructive sleep apnea/hypoapnoea syndrome: definitions, epidemiology, and natural history. Thorax. 2004;59;(1):73-78. [Crossref]  [PubMed]  [PMC] 
  32. Irwin M, McClintick J, Costlow C, Fortner M, White J, Gillin JC. Partial night sleep deprivation reduces natural killer and cellular immune responses in humans. FASEB J. 1996;10(5): 643-653. [Crossref]  [PubMed] 
  33. Irwin M, Thompson J, Miller C, Gillin JC, Ziegler M. Effects of sleep and sleep deprivation on catecholamine and interleukin-2 levels in humans: clinical implications. J Clin Endocrinol Metab. 1999;84(6):1979-1985. [Crossref]  [PubMed] 
  34. Zhao J, Dai YH, Xi QS, Yu SY. A clinical study on insomnia in patients with cancer during chemotherapy containing high-dose of glucocorticoids. Pharmazie. 2013;68(6):421-427.
  35. George M, Elias A, Shafiei M. Insomnia in cancer--associations and implications. Asian Pac J Cancer Prev. 2015;16(15):6711-6714. [Crossref]  [PubMed] 
  36. Savard J, Ivers H, Savard MH, Morin CM. Cancer treatments and their side effects are associated with aggravation of insomnia: results of a longitudinal study. Cancer. 2015;121(10):1703-1711. [Crossref]  [PubMed] 
  37. Stein KD, Denniston M, Baker F, et al. Validation of modified rotterdam symptom checklist for use with cancer patients in the United States. J Pain Symptom Manage. 2003;26(5): 975-989. [Crossref] 
  38. Nishiura M, Tamura A, Nagai H, Matsushima E. Assessment of sleep disturbance in lung cancer patients: relationship between sleep disturbance and pain, fatigue, quality of life, and psychological distress. Palliat Support Care. 2015;13(3):575-581. [Crossref]  [PubMed] 
  39. Renom-Guiteras A, Planas J, Farriols C, et al. Insomnia among patients with advanced disease during admission in a palliative care unit: a prospective observational study on its frequency and association with psychological, physical and environmental factors. BMC Palliat Care. Aug 2014;13:40. [Crossref]  [PubMed]  [PMC] 
  40. Mercadante S, Aielli F, Adile C, et al. Sleep disturbances in patients with advanced cancer in different palliative care settings. J Pain Symptom Manage. 2015;50(6):786-792. [Crossref]  [PubMed] 
  41. Delgado-Guay M, Yennurajalingam S, Parson H, Palmer JL, Bruera E. Association between self-reported sleep disturbances and other symptoms in patients with advanced cancer. J Pain Symptom Manage. 2011;41(5):819-827. [Crossref]  [PubMed] 
  42. Ateşci FÇ, Oğuzhanoğlu NK, Baltalarlı B, Karadağ F, Özdel O, Karagöz N. Psychiatric disorders in cancer patients and associated factors. Türk Psikiyatri Dergisi. 2003;14(2): 145-152.
  43. National Cancer Institute (NIH). nt&language=English.
  44. Jadoon NA, Munir W, Shahzad MA, Choudhry ZS. Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study. BMC Cancer. 2010;(10):594. [Crossref]  [PubMed]  [PMC]