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

Abstract

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.

Health-related quality of life among patients with advanced cancer: an integrative review

“…Finally, eight studies addressed the signs and the symptoms that negatively affected the HRQoL of patients with advanced cancer (25)(26)(27)(28)(29)(30)(31)(32) (Chart 2). Insertion of self-expandable metal prosthesis in the esophagus and in the bile ducts, and percutaneous nephrostomy.…”

“…Mystakidou, Parpa, Tsilaka et al (27) Assessment of the relationship between sleep quality and pain, QOL, post-traumatic experience, depression and psychological stress.…”

“…In the analysis of the studies included in this literature review, we highlight eight articles that described signs and symptoms that negatively affected the QOL of patients suffering from advanced cancer in the final stage of life (25)(26)(27)(28)(29)(30)(31)(32) . Among the signs and symptoms cited in the studies we highlight those by orders of magnitude: pain, fatigue, poor quality sleep, discomfort with an increased frequency, severity of symptoms, depression, dysphagia, poor appetite, poor nutritional status, changes in the sense of taste, lack of family and social support, and a sense of dependence.…”

“…Two cross-sectional studies with a total of 82 and 83 patients with advanced cancer, as assessed by McMaster Quality of Life Scale (MQOLS)(26) and the 12-Item Short Form Health Survey (SF -12) (27) , respectively, showed that perception of psychological well-being and QoL among patients in palliative care was shown to be significantly affected by pain and poor quality of sleep, causing strong impact in the daily QoL. The poor quality of sleep can cause many physical and cognitive symptoms such as decreased concentration, signs of fatigue, increased levels of anxiety, nervousness, irritability, gastrointestinal symptoms and predisposition to accidents.…”

“…The poor quality of sleep can cause many physical and cognitive symptoms such as decreased concentration, signs of fatigue, increased levels of anxiety, nervousness, irritability, gastrointestinal symptoms and predisposition to accidents. These symptoms, especially when associated, are predictors that affect the well-being and cause negative impact on QoL (27) .…”