Sleep Disorders and Psychological Profile in Oral Cancer Survivors: A Case-Control Clinical Study

Abstract

Quality of sleep (QoS) and mood may impair oral cancer survivors’ wellbeing, however few evidences are currently available. Therefore, we aimed to assess the prevalence of sleep disorders, anxiety and depression among five-year oral cancer survivors (OC survivors). 50 OC survivors were compared with 50 healthy subjects matched for age and sex. The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Hamilton Rating Scales for Depression and Anxiety (HAM-D, HAM-A), the Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI) were administered. The global score of the PSQI, ESS, HAM-A, HAM-D, NRS, T-PRI, was statistically higher in the OC survivors than the controls (p-value: <0.001). QoS of OC survivors was significantly impaired, especially with regard to some PSQI sub-items as the subjective sleep quality, sleep latency and daytime dysfunction (p-value: 0.001, 0.029, 0.004). Moreover, poor QoS was negatively correlated with years of education (p-value: 0.042 *) and positively correlated with alcohol consumption (p-value: 0.049 *) and with the use of systemic medications (p-value: 0.044 *). Sleep disorders and mood disorders are common comorbidities in OC survivors; therefore, early assessment and management before, during and after treatment should be performed in order to improve the quality of life of OC survivors.

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

“…Consistent with prior studies that reported associations between anxiety and sleep disturbance as single symptom decrements in QOL in both oncology patients 88,89 and general populations, 90,91 for all of the general and disease-specific QOL domains, as the anxiety and sleep disturbance profiles worsened, all aspects of QOL were impacted. Of note, for both the PCS and MCS scores, patients with the 2 worst profiles reported scores of less than 50, which is lower than the normative score for the general population.…”

Clinical Spectrum and Trajectory of Innovative Therapeutic Interventions for Insomnia: A Perspective

“…A Mendelian randomization study indicates the increased risk of lung adenocarcinoma and squamous cell lung cancer among insomnia patients [ 197 ]. A systematic review indicates that frequencies of insomnia are variably prevalent among different types of cancer patients in the range of 30%-93.1% [ 198 , 199 ]. Insomnia also prevails in survivors of oral/head-neck cancer, and lung cancer [ 198 , 200 , 201 ], which might be attributed to stress, anxiety, depression, and pain, particularly among patients treated with chemotherapy [ 202 ].…”

“…A systematic review indicates that frequencies of insomnia are variably prevalent among different types of cancer patients in the range of 30%-93.1% [ 198 , 199 ]. Insomnia also prevails in survivors of oral/head-neck cancer, and lung cancer [ 198 , 200 , 201 ], which might be attributed to stress, anxiety, depression, and pain, particularly among patients treated with chemotherapy [ 202 ]. It is of note that though scientific evidence is accumulating on the correlation between insomnia to cancer initiation and progression, the pathologic flow in the terms of mono-or bidirectional nature still needs to be investigated.…”

Impact of free flap reconstruction on obstructive sleep apnea in patients with oral and oropharyngeal cancer

“… 2 A recently published study demonstrated that sleep disorders are common among patients with head and neck cancer, which may affect cancer survivors' well-being and exacerbate the burden of disease. 3 However, the causes of sleep disturbances among patients with head and neck cancer are unclear and have not been well studied. Obstructive sleep apnea (OSA) is a common sleep disorder characterized by the repetitive collapse of the upper airway during sleep, leading to the intermittent cessation or reduction of airflow (apnea and hypopnea, respectively) and dips in arterial oxygen saturation during sleep.…”