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Patient Care
June 20, 2007

Prevalence of insomnia and associated symptoms in patients with cancer


Background: High rates of insomnia have been reported in patients undergoing treatment for cancer. The etiology of insomnia in these patients is unknown, but may be related to psychological factors (anxiety or depression), pain, treatment-related toxicity, or other co-morbid medical conditions. Insomnia has been linked with increased rates of depression, decreased quality of life, and increased fatigue in other patient populations, and is therefore important to understand in the context of cancer. Methods: The Patient Care Monitor (PCM; Supportive Oncology Services, Memphis, TN) is a validated software package assessing oncology-related patient symptoms using a 11- point Likert scale. This instrument is administered routinely to patients at each office visit at most community oncology clinics within the Accelerated Community Oncology Research Network (ACORN). Cross-sectional patient-reported data from 11,445 consecutive patients evaluated at ACORN sites are presented here. Results: The mean age of the sample was 61.5 (±14.2; range 18–95), and 74.3% was female. 25% had received chemotherapy within the prior month. The sample size by tumor site was as follows: breast- 3,316; GU- 2,966; GI- 1,634; hematologic- 1,373; lung- 1,224; head and neck- 501; skin- 321. 55% of the pts reported trouble sleeping, with 26% describing this trouble as moderate or severe. Mean values from patient reported symptoms on the PCM are reported below. 21.9% of patients without insomnia had recent chemotherapy, compared with 27.5% of patients with insomnia who had recent therapy (p<.001). Conclusions: Insomnia occurs commonly in patients with cancer, and is associated with significantly increased fatigue, pain, and depressed mood. Additional research will explore changes in insomnia over the course of treatment, and relate these to possible etiological factors.
Patient Reported Symptoms
 No Insomnia n=5,151Mod-Severe Insomnia n=3,031tp-value
Fatigue or Tiredness2.385.23-45.53<.0001
Physical Pain1.584.33-40.38<.0001
Sad or Depressed0.692.56-29.56<.0001
No significant financial relationships to disclose.

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Published In

Journal of Clinical Oncology
Pages: 9098


Published online: June 20, 2007
Published in print: June 20, 2007


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E. J. Stepanski
Accelerated Community Oncology Research Network, Memphis, TN
L. S. Schwartzberg
Accelerated Community Oncology Research Network, Memphis, TN
L. J. Blakely
Accelerated Community Oncology Research Network, Memphis, TN
D. Fu
Accelerated Community Oncology Research Network, Memphis, TN
B. V. Fortner
Accelerated Community Oncology Research Network, Memphis, TN

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E. J. Stepanski, L. S. Schwartzberg, L. J. Blakely, D. Fu, B. V. Fortner
Journal of Clinical Oncology 2007 25:18_suppl, 9098-9098

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