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. 2017 Apr:32:208-212.
doi: 10.1016/j.sleep.2016.06.041. Epub 2017 Jan 20.

Sleep duration is associated with survival in advanced cancer patients

Kevin P Collins  1 , David A Geller  1 , Michael Antoni  2 , Drew Michael Donnell  3 , Allan Tsung  1 , James W Marsh  1 , Lora Burke  4 , Frank Penedo  5 , Lauren Terhorst  6 , Thomas W Kamarck  7 , Anna Greene  1 , Daniel J Buysse  8 , Jennifer L Steel  9
Affiliations

Sleep duration is associated with survival in advanced cancer patients

Kevin P Collins et al. Sleep Med. 2017 Apr.

Abstract

Objective: Sleep problems have been linked to increased risk of mortality in the general population. Limited evidence suggests similar relationships among people diagnosed with cancer. The aims of the present study were to investigate the type and rates of sleep problems in advanced cancer patients and examine whether sleep problems are associated with survival.

Methods: A prospective study of 292 patients with advanced cancers affecting the hepatobiliary and pancreatic systems were administered a battery of questionnaires measuring sociodemographic information, sleep, and depression. Descriptive statistics, ANOVA, Chi-square, Kaplan-Meier survival, and Cox regression analyses were performed to test the aims.

Results: The majority of patients were male (64%) and the mean age was 62 years (SD = 11). Fifty-nine percent of patients reported poor sleep quality; 43% reported sleeping ≤6 h and 2% ≥10 h; 40% reported sleep latency of 30 min or greater; average sleep efficiency was 80%. Of the 292 patients, 58% reported clinically levels of depression and depressive symptoms were related to shorter sleep duration (p = 0.02). After adjusting for factors known to contribute to survival, a curvilinear relationship was observed between sleep duration and mortality: short and long sleep duration were associated with increased mortality [linear term: hazard ratio (HR) = 0.485, 95% confidence interval (CI) = 0.275-0.857; quadratic term: HR = 1.064, 95% CI = 1.015-1.115].

Conclusions: Consistent with findings in the general population, a curvilinear relationship between sleep duration and mortality was observed in advanced cancer patients. The high prevalence of sleep problems and link with mortality warrants routine screening and development of evidence-based treatments for sleep problems in the oncology setting.

Keywords: Cancer; Hepatobiliary; PSQI; Sleep; Sleep duration; Survival.

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Conflict of interest statement

Conflict of interest

Figures

Fig. 1
Fig. 1
Smooth Log hazard ratio across sleep duration. The dotted lines represent the upper and lower bounds of the 95% confidence intervals
See this image and copyright information in PMC

References

    1. Fortner BV, Stepanski EJ, Wang SC, Kasprowicz S, Durrence HH. Sleep and quality of life in breast cancer patients. Journal of Pain and Symptom Management. 2002;24(5):471–80. - PubMed
    1. Dean GE, Redeker NS, Wang YJ, et al. Sleep, mood, and quality of life in patients receiving treatment for lung cancer. Oncology Nursing Forum. 2013;40(5):441–51. - PMC - PubMed
    1. Zeitlhofer J, Schmeiser-rieder A, Tribl G, et al. Sleep and quality of life in the Austrian population. Acta Neurol Scand. 2000;102(4):249–57. - PubMed
    1. Doi Y, Minowa M, Uchiyama M, Okawa M. Subjective sleep quality and sleep problems in the general Japanese adult population. Psychiatry Clin Neurosci. 2001;55(3):213–5. - PubMed
    1. Palesh O, Peppone L, Innominato PF, et al. Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer. Nature and Science of Sleep. 2012;4:151–162. - PMC - PubMed