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Self-reported sleep quality as prognostic for survival in lung cancer patients

Authors Gottfried T, Kamer I, Salant I, Urban D, Lawrence YR, Onn A, Bar J

Received 16 October 2019

Accepted for publication 4 December 2019

Published 15 January 2020 Volume 2020:12 Pages 313—321


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo

Teodor Gottfried, 1 Iris Kamer, 1 Iris Salant, 1 Damien Urban, 1 Yaacov R Lawrence, 2, 3 Amir Onn, 4 Jair Bar 1, 3

1Chaim Sheba Medical Center, Institute of Oncology, Ramat Gan 5262000, Israel; 2Department of Radiation Oncology, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel; 3Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel; 4Chaim Sheba Medical Center, Pulmonology Institute, Ramat Gan 5262000, Israel

Correspondence: Jair Bar
Institute of Oncology, Chaim Sheba Medical Center, Ramat Gan 5262000, Israel
Tel + 972 3530-7096
Fax +972 3530-7097

Purpose: Sleep is essential for life, as well as having a major impact on quality of life. Not much attention has been given to this important factor in the care of lung cancer patients.
Patients and Methods: We retrospectively analyzed a cohort of 404 lung cancer patients treated in our institute between 2010 and 2018. Data about sleep quality, distress and pain were self-reported by questionnaires administered to patients at their first clinic visit to the Institute of Oncology. Sex, age, histology, stage, smoking and marital status were extracted from the patients’ charts. Uni- and multi-variate analyses were carried out to evaluate the correlation of these factors with survival.
Results: Most patients reported some level of distress and pain. Sleep abnormalities were reported by 58.7% of patients. Distress, pain and bad sleep were correlated with shorter survival in univariate analyses; however, only sleep remained associated with survival in multivariate analysis. Patients reporting bad sleep had a median survival of 16 months, compared to 27 months for patients reporting good sleep (hazard ratio 1.83, 95% C.I. 1.27– 2.65). Frequent arousals at night were more tightly correlated with survival than difficulty falling asleep.
Conclusion: Sleep quality, as reported by lung cancer patients, is highly correlated with survival. Further studies are required to comprehend whether poor sleep quality is directly impacting survival or is a result of the cancer aggressiveness and patients’ conditions.

Keywords: lung cancer, sleep quality, survival, distress, pain, patient-reported outcomes

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