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Supportive Care in Cancer

, Volume 25, Issue 4, pp 1301–1306 | Cite as

Sleep disturbances in advanced cancer patients admitted to a supportive/palliative care unit

  • Sebastiano MercadanteEmail author
  • Claudio Adile
  • Patrizia Ferrera
  • Francesco Masedu
  • Marco Valenti
  • Federica Aielli
Original Article

Abstract

The aim of this study was to assess the prevalence of sleep disturbances and possible correlations with associated factors in a sample of patients admitted to an acute palliative/supportive care unit.

A consecutive sample of patients with advanced cancer was prospectively assessed for a period of 6 months. Epidemiological and clinical data, treatments received in the last month, Karnofsky status, Edmonton Symptom Assessment System (ESAS), and concomitant medical treatment were also recorded. Patients were administered the Athens Insomnia Scale (AIS) and the Hospital Anxiety and depression scale (HADS).

Two hundred nineteen patients met the inclusion criteria. The mean age was 65.4 years (SD 12.4), and 111 patients were males. The mean Karnofsky status was 46.6 (SD = 12). All patients had consistent sleep disturbances (AIS ≥6), with a large number of patients having intense-maximum sleep disturbances. No relationships of AIS with gender, age, primary diagnosis, socio-educational factors, and anticancer treatments were found. AIS score was significantly associated with Karnofsky; intensities of pain, asthenia, anorexia, anxiety, depression, drowsiness, and well-being; and the use of corticosteroids and benzodiazepines. There was a positive correlation of HADS anxiety and HADS depression with sleep disturbances (p = 0.000). In the multivariate analysis, AIS increased only with the level of anxiety and depression assessed by HADS.

Sleep disturbances were ubiquitous in advanced cancer patients admitted to a supportive/palliative care unit and were strongly correlated with psychological distress. Assessment of sleep disorders is mandatory in this population for the obvious interference with quality of life.

Keywords

Sleep disturbances Insomnia Palliative care Advanced cancer 

Notes

Compliance with ethical standards

Informed consent was obtained. The study conforms to the principal outline by the Declaration of Helsinki and was approved by the local ethical committee.

Conflict of interest

The authors declare that they have no conflict of interest.

Financial support

The study did not receive any financial support.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Sebastiano Mercadante
    • 1
    Email author
  • Claudio Adile
    • 1
  • Patrizia Ferrera
    • 1
  • Francesco Masedu
    • 2
  • Marco Valenti
    • 2
  • Federica Aielli
    • 2
  1. 1.Pain relief and supportive care unitLa Maddalena Cancer CenterPalermoItaly
  2. 2.Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental MedicineUniversity of L’AquilaL’AquilaItaly

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