How is sleep quality affected by the psychological and symptom distress of advanced cancer patients?

• Published in: Palliative medicine Vol. 23; no. 1; pp. 46 - 53
• Main Authors: Mystakidou, K, Parpa, E, Tsilika, E, Gennatas, C, Galanos, A, Vlahos, L
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2009; Sage Publications Ltd
• Subjects: Adult; Aged; Aged, 80 and over; Analysis of Variance; Cancer; Clinical medicine; Cognition; Cognitive ability; Depression; Depressive Disorder - psychology; Female; Hopelessness; Hospitals; Humans; Insomnia; Male; Medicine; Mental depression; Middle Aged; Neoplasms - complications; Neoplasms - psychology; Pain; Pain - psychology; Pain Measurement; Palliative Care; Patients; Post traumatic stress disorder; Quality of Life; Sleep disorders; Sleep problems; Sleep Wake Disorders - psychology; Stress, Psychological - complications; Substance abuse treatment; Terminally Ill - psychology; Terminally ill people; United States > US; Pittsburgh Pennsylvania; Greece; Pittsburgh sleep quality index; pain; hopelessness; depression; post-traumatic experience; advanced cancer patients
• ISSN: 0269-2163; 1477-030X
• DOI: 10.1177/0269216308098088

The aim of this study was to assess the relationship between sleep quality, pain, psychological distress, cognitive status and post-traumatic experience in advanced cancer patients. Participants were 82 advanced cancer patients referred to a palliative care unit for control of pain and other symptoms. A variety of assessment tools were used to examine the prevalence of sleep disturbance, the severity of pain and depression, hopelessness, cognitive function and quality of life. Using the Pittsburgh Sleep Quality Index (PSQI) 96% of patients were ‘poor sleepers’. Statistically significant associations were found between PSQI and the SF-12 (Short Form-12) Quality of Life Instrument (MCS, P < 0.0005, PCS, P < 0.0005), depression (Greek Depression Inventory) (P < 0.0005) and hopelessness (Beck Hopelessness Scale) (P = 0.003). Strong associations were also found between PSQI and IES-R (Impact of Event Scale-Revised) (P = 0.004). The strongest predictors of poor sleep quality in this model were MCS (P < 0.0005), PCS (P < 0.0005) and IES-R (P = 0.010). Post-traumatic experience and quality of life seemed to be the strongest predictors of sleep quality in a sample of advanced cancer patients referred for palliative care.