Greater sleep disturbances associated with external factors in patients with gastrointestinal cancers


Higher levels of sleep disturbances were associated with certain factors such as younger age, a high rate of co-morbidities and a high number of previous cancer treatments in patients with gastrointestinal (GI) cancers, according to a presentation from the recent 2021 Oncology Nursing Society (ONS) Annual Meeting.

According to Yufen Lin MSN, RN, of Duke University School of Nursing, chemotherapy is a common primary treatment for various gastrointestinal cancers and therefore sleep disturbances are a common and distressing symptom of this treatment. These disturbances often lead to a decrease in patients’ functional status, responses to treatment and quality of life (QOL).

Previous studies have focused on various aspects of sleep disruption and its impact on cancer patients, including risk factors, but few have looked at the characteristics of sleep or combined all of this information into one study.

“Most of the studies have focused on patients with breast cancer, lung cancer and prostate cancer,” Lin said in his presentation. “Less is known about sleep disturbances in patients with gastrointestinal cancer.”

Therefore, Lin and his team took a “person-centered approach” to identify the subsets of gastrointestinal cancer patients with distinct sleep disturbance profiles and to assess the differences between these subgroups in this regard. which concerns demographic, clinical and sleep characteristics, concomitant symptoms, as well as quality of life outcomes.

To do this, 405 participants were asked to complete questionnaires 6 times over 2 cycles of chemotherapy. Levels of sleep disturbance were assessed using the General Sleep Disturbance Scale (GSDS). It was also the first study to use Latent Profile Analysis (LPA) to identify subgroups of gastrointestinal cancer patients with distinct sleep disturbance profiles.

In this analysis, researchers assessed differences in demographic, clinical, and sleep characteristics, concomitant symptoms, and quality of life outcomes among subgroups, using parametric and nonparametric analyzes.

In total, 3 different classes of sleep disorders were identified in the six assessments: low (35.8%), high (48.6%) and very high (15.6%). Compared with patients in the low group, those in the high and very high groups were significantly younger, had more co-morbidities, had a greater number of previous cancer treatments, were less likely to be married or in a relationship, and were less likely to be married or in a relationship. likely to exercise. on a regular basis.

Compared to the low group, patients in the very high sleep disorder class were less likely to be employed and were diagnosed with back pain; they were also more likely to report having childcare responsibilities.

Among the 3 classes of sleep disorders, significant differences that gradually increased in each group were found for burden of comorbidity, occurrence of depression, GSDS subscale, and total scores. Additionally, patients in the very high group reported higher levels of anxiety, depressive symptoms, morning and evening fatigue, and pain, with lower levels of attentional function and quality of life scores at time of day. ‘registration.

According to Lin, these findings provide new insight into the risk factors and concomitant symptoms that could lead to higher levels of sleep disturbance in patients with gastrointestinal cancers, which may, in turn, help providers. health care providers to identify and resolve these problems before they arise. start.

“Clinicians can use common and distinct factors to identify high-risk patients with sleep disturbance, and also initiate appropriate sleep hygiene education and referrals,” Lin said.

Additionally, these findings underscored the need for further research into the underlying mechanisms that contribute to the development of sleep disturbances and may prompt providers to develop personalized symptom management interventions to reduce symptom burden and improve health outcomes. quality of life.

Reference

Yufen L., Bailey D., Docherty S. Distinct sleep disturbance profiles in gastrointestinal cancer patients receiving chemotherapy. Presented at the 46th Annual Meeting of the Society of Oncology Nursing; April 20, 22, 27 and 29, 2021. Last Minute Summary # 5.


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