Insomnia Prevalence and Correlates in Cancer Patients Undergoing Treatment
Nadine J. McCleary and Eric S. Zhou are Co-Senior authors.
Funding: This work was supported by a Clinician Scientist Development Grant (CSDG-21-080-01 – CTPS) from the American Cancer Society.
ABSTRACT
Background
Insomnia is the most common sleep disturbance among cancer patients undergoing active treatment. If untreated, it is associated with significant physical and psychological health consequences. Prior efforts to determine insomnia prevalence and correlates have primarily assessed patients in clinical trials, in limited disease groups, and excluding important patient subgroups. These findings are likely to be influenced by research participation effects, which could bias outcomes. We sought to address these limitations in a large, real-world sample.
Methods
Between 2018 and 2021, all patients seen at our institution were offered an electronic patient-reported outcomes (PRO) questionnaire where they could self-report on a range of symptoms based on the National Cancer Institute's PRO-CTCAE. Medical records were abstracted for demographics and cancer diagnosis/treatment. We evaluated N = 9350 patients for whom there was complete data.
Results
During cancer treatment, 21% of patients reported insomnia symptoms. Demographically, prevalence was higher in patients who were female (22% vs. 19%), younger than 60 years of age (22% vs. 20%), non-White (24% vs. 20%), and on public insurance (22% vs. 20%). Medically, patients undergoing palliative treatment were more likely to report insomnia symptoms, irrespective of cancer site (23% vs. 19%). The prevalence of insomnia symptoms ranged from 18% (genitourinary) to 23% (gastrointestinal).
Conclusion
More than 1 in 5 cancer patients suffer from symptoms of insomnia. It is important that oncologists and cancer centers routinely assess insomnia severity in their patients. Leveraging the use of existing patient-reported outcomes at an institution may be important to help with the identification of insomnia symptoms.
Conflicts of Interest
Eric S. Zhou has received research funding from Jazz Pharmaceuticals and Harmony Biosciences, and consulting fees from MindUP and Samsung, for work unrelated to the subject of this manuscript.
Open Research
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
