Oncology Outpatients With Worse Anxiety and Sleep Disturbance Profiles Are at Increased Risk for a Higher Symptom Burden and Poorer Quality of Life

Abstract

Background Anxiety and sleep disturbance are frequent symptoms during chemotherapy. Objectives Purposes were to identify subgroups of oncology outpatients with distinct joint anxiety and sleep disturbance profiles, as well as evaluate for differences in demographic and clinical characteristics, sleep disturbance characteristics, severity of common symptoms, and quality-of-life outcomes among these subgroups. Methods Oncology outpatients (n = 1331) completed self-report measures of anxiety and sleep disturbance 6 times over 2 chemotherapy cycles. Latent profile analysis was done to identify subgroups of patients with distinct joint anxiety and sleep disturbance profiles. Results Three profiles were identified (ie, no anxiety and low sleep disturbance (59.7%), moderate anxiety and high sleep disturbance (32.5%), high anxiety and very high sleep disturbance (7.8%)). Compared with the no anxiety and low sleep disturbance class, the other 2 classes were younger; less likely to be married; had a lower annual household income; and had childcare responsibilities. Patients in the 2 worse profiles had problems with both sleep initiation and maintenance. These patients reported higher levels of depressive symptoms, trait and state anxiety, and evening fatigue, as well as lower levels of morning and evening energy, cognitive function, and poorer quality of life. Conclusions More than 40% of patients had moderate or high levels of anxiety and high or very high levels of sleep disturbance. Modifiable risk factors associated with these profiles may be used to develop targeted interventions for 1 or both symptoms. Implications for Practice Clinicians need to assess for the co-occurrence of anxiety and sleep disturbance.

A Bibliometric Analysis of the 36-Year History of Cancer Nursing (1987-2023)

“…Today, the rate of breast cancer survivors is high, due to advances in early diagnosis and treatment. Efforts to improve the quality of life of these individuals, who have many needs, are of critical importance in nursing care practice 30,31 . Chemotherapy is an important component of cancer treatment 32 .…”

“…to improve the quality of life of these individuals, who have many needs, are of critical importance in nursing care practice. 30,31 Chemotherapy is an important component of cancer treatment. 32 At the same time, the common adverse effects of chemotherapy in cancer patients may have led to its frequent use by authors (https://www.cdc.gov/cancer/preventinfections/providers.htm).…”

“…32 At the same time, the common adverse effects of chemotherapy in cancer patients may have led to its frequent use by authors (https://www.cdc.gov/cancer/preventinfections/providers.htm). 31 In the keyword analysis, "breast cancer," "fatigue," and "decision making" were the keywords that clustered together. Fatigue is the most common symptom associated with cancer treatment in individuals with cancer.…”

Sleep disturbance and decrements in morning energy contribute to a higher symptom burden in oncology patients

“…Equally important, in both cross-sectional and longitudinal studies of oncology patients, positive associations were identified between sleep disturbance and fatigue [11][12][13], depression [12,[14][15][16], and anxiety [6,[17][18][19][20]. In a longitudinal study that evaluated for changes in the cooccurrence of sleep disturbance and fatigue in women undergoing chemotherapy for breast cancer using latent profile analysis (LPA) [21], three groups of patients were identified prior to the initiation of chemotherapy (i.e., Fatigued with Sleep Complaints, Average, Minimal 2 Symptoms).…”

Visual analysis of the research frontiers, hotspots and trends of exercise therapy intervention in tumor-related sleep-wake disorders

“…It typically presents in the form of “clusters” of symptoms, including pain, anxiety, depression, fatigue, and decreased morning energy ( 4 , 5 ). The severity of this syndrome is positively correlated with cognitive dysfunction, quality of life, cancer survival, and disease burden ( 6 – 8 ) and, if it does not achieve long-term remission, can cause insomnia ( 9 ), complicating the management of sleep-wake disorders in oncology ( 5 ). The study concluded that: sleep-wake disorders in cancer patients may be independent of the time of diagnosis of the disease and the location of the tumor, but independently related to their quality of life ( 10 ).…”