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Long-term sleep disturbance and prescription sleep aid use among cancer survivors in the United States

Abstract

Purpose

Insomnia and related sleep disorders are common complaints among cancer patients, and use of prescription sleep aids can be high in the treatment setting. The prevalence of sleep disturbance and prescription sleep aid use in the community-dwelling cancer survivorship population, however, remains relatively unexplored. We aim to ascertain the extent to which a cancer diagnosis is associated with sleep disturbances and prescription sleep aid use as measured in several cross sections of individuals across multiple disease sites and time since cancer diagnosis.

Methods

We used data from five cross-sectional cycles of the National Health and Nutrition Evaluation Survey (NHANES) from 2005 to 2014. We identified a total of 2371 individuals who reported a diagnosis of cancer (averaging 61 years old) and 25,788 individuals who did not report a cancer diagnosis (averaging 45 years old). We considered several patient-reported sleep-related outcomes. Multivariate regression analyses, as well as propensity score matching, were used to clarify the relationship between sleep disturbances, prescription sleep aid use, and cancer diagnosis, stratified by time since diagnosis and primary disease site.

Results

Reported sleep disturbance was common in cancer survivors, with approximately 34% of patients with a history of cancer reporting having ever been told they had trouble sleeping, compared to 23% of non-cancer patients in the general population with no history of cancer (p < 0.001). Propensity score matching supported a significantly higher rate of trouble sleeping among cancer survivors compared to matched controls. Compared to the general adult population without cancer, cancer survivors 11 or more years past diagnosis were more likely to report being diagnosed with trouble sleeping or a sleep disorder. Further, patients with gynecological cancers were more likely to report prescription sleep aid use, sleep disorders, and trouble sleeping compared to adults without a history of cancer.

Conclusions

Sleeping problems are common in the cancer survivorship population, especially in patients with a long survivorship history and a history of gynecological cancers. Consideration of symptoms of insomnia and sleep disturbance may be helpful in the follow-up care of these patients.

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Data

The NHANES data used in this study is publicly available through the Centers for Disease Control and Prevention, National Center for Health Statistics. It is available electronically at http://www.cdc.gov/nchs/nhanes.htm.

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Correspondence to Alexander N. Slade.

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Slade, A.N., Waters, M.R. & Serrano, N.A. Long-term sleep disturbance and prescription sleep aid use among cancer survivors in the United States. Support Care Cancer 28, 551–560 (2020). https://doi.org/10.1007/s00520-019-04849-3

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Keywords

  • Sleep disturbance
  • NHANES
  • Prescription sleep aid
  • Cancer survivorship