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Insomnia prevalent among cancer patients

Issue: October 25, 2009

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There was a high prevalence of insomnia among patients with cancer during the perioperative period, particularly for those with breast and gynecologic cancers.

Researchers from Laval University Cancer Research Center in Québec, Canada, conducted a prospective study to examine the association between insomnia and cancer. Patients with nonmetastatic cancer (n=991) completed self-report scales and interviews at the perioperative phase and again two months later.

At baseline, 28.5% of patients had insomnia, 31% had insomnia symptoms and 40.5% were good sleepers. At two months, the number of patients with insomnia syndrome decreased to 26.2% (P=.07); 22.2% had insomnia symptoms (P < .001) and the number of good sleepers increased to 52% (P <.001).

Patients who had surgery before the study had a higher prevalence of insomnia compared with patients who did not (P=.008). Patients who did not have surgery were also more likely to be good sleepers (P <.001).

At two months, the highest rates of insomnia prevalence were observed among patients with breast cancer (31.3%) and gynecologic cancer (28.4%); patients with prostate cancer had the lowest rates (15.9%).

Among patients who were good sleepers at baseline, 18.6% developed insomnia symptoms or syndrome, whereas 32% who had insomnia became good sleepers.

Those at higher risk for insomnia incidence included patients who were women (OR=2.77; 95% CI, 1.39-5.50), who had an arousability trait (OR=1.05; 95% CI, 1.00-1.10), had head or neck cancer (OR=5.92; 95% CI, 0.98-35.76), experienced increased anxiety symptoms (OR=1.13; 95% CI, 1.03-1.25) or had cancer surgery (OR=2.64; 95% CI, 1.31-5.31).

Higher baseline levels and increases from baseline to two months for dysfunctional beliefs about sleep (OR=1.28; 95% CI, 1.07-1.53), sleep monitoring (OR=1.04; 95% CI, 1.02-1.06) and maladaptive sleep behaviors (OR=2.04; 95% CI, 0.92-4.51) were risk factors for insomnia persistence.

Savard J. J Clin Oncol. 2009;doi:10.1200/JCO.2008.21.6333.