Predictors of the trajectories of self-reported sleep disturbance in men with prostate cancer during and following radiation therapy

University of California, San Francisco, CA, USA.
Sleep (Impact Factor: 4.59). 02/2011; 34(2):171-9.
Source: PubMed


To examine how self-reported ratings of sleep disturbance changed from the time of the simulation visit to four months after the completion of radiation therapy (RT) and to investigate whether specific patient, disease, and symptom characteristics predicted the initial levels of sleep disturbance and/or characteristics of the trajectories of sleep disturbance.
Prospective longitudinal study.
Two radiation therapy centers.
Patients (n = 82) who underwent primary or adjuvant RT for prostate cancer.
Changes in self-reported sleep disturbance were measured using the General Sleep Disturbance Scale (GSDS). Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale. Trait and state anxiety were measured using the Spielberger State-Trait Anxiety Inventory. Hierarchical linear modeling was used to answer the study aims. Self-reported sleep disturbance increased during the course of RT and then decreased following the completion of RT. Predictors of higher levels of sleep disturbance included younger age, higher levels of trait anxiety, higher levels of depressive symptoms, and higher levels of sleep disturbance at the initiation of RT.
Sleep disturbance is a significant problem in patients with prostate cancer who undergo RT. Younger men with co-occurring depression and anxiety may be at greatest risk for sleep disturbance during RT.

Download full-text


Available from: Laura B Dunn, Feb 02, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Sleep disturbance is a significant problem for both oncology patients and family caregivers (FCs), and is associated with poorer functional status, quality of life, and potentially disease progression. This review describes a comprehensive literature search and meta-analysis of the efficacy of interventions for sleep disturbance in oncology patients and their FCs. This search revealed 47 studies that evaluated the effects of a number of interventions on sleep disturbance/sleep quality, as a primary or secondary outcome in oncology patients. The primary purposes of the review were to synthesize findings from intervention studies for sleep disturbance in oncology patients and their FCs; to evaluate the efficacy of these interventions; to identify gaps in the literature; and to provide directions for future research. In addition, all 47 intervention studies were evaluated in terms of key intervention and study characteristics. Both strong patterns and inconsistencies were identified among the studies, which complicate an evaluation of the efficacy of interventions, and may collectively guide future research. Finally, the importance of including the FC in sleep disturbance interventions is discussed. In light of the detrimental effects that sleep disturbance has on both the patient and the FC, this systematic review may better inform essential future intervention efforts.
    No preview · Article · Nov 2011 · Sleep Medicine Reviews
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to evaluate for differences in occurrence and severity ratings of sleep disturbance, fatigue, and decreased energy in women who reported breast pain prior to surgery for breast cancer. Of the 390 women who completed self-report measures for each symptom, 28.2% reported pain in their breast prior to surgery. A higher percentage of women in the pain group (i.e., 66.7% versus 53.5%) reported clinically meaningful levels of sleep disturbance. However, no between group differences were found in the severity of sleep disturbance, fatigue, or decreased energy. Findings from this study suggest that sleep disturbance, fatigue, and decreased levels of energy are significant problems for women prior to breast cancer surgery. Future studies need to evaluate for specific characteristics that place women at greater risk for these symptoms as well as the mechanisms that underlie these symptoms.
    No preview · Article · Jul 2012 · Breast (Edinburgh, Scotland)
  • [Show abstract] [Hide abstract]
    ABSTRACT: CONTEXT: Little is known about changes over time in multiple dimensions of the symptom experience in patients with breast cancer undergoing radiation therapy (RT). OBJECTIVES: This study evaluated for changes in and predictors of occurrence, severity, and distress of six common symptoms (lack of energy, worrying, difficulty sleeping, feeling drowsy, sweats, and pain) during RT for breast cancer. METHODS: Patients (n = 188) completed the Memorial Symptom Assessment Scale before, during, and after the completion of RT, over a six month period. Changes in symptom occurrence were evaluated using multilevel logistic regression analysis. Changes in severity and distress scores were evaluated using multilevel proportional odds ordinal logistic regression. The impact of five demographic and clinical characteristics (age, functional status, comorbidities, axillary lymph node dissection, and previous chemotherapy) was evaluated in these analyses. RESULTS: The trajectories for occurrence, severity, and distress for the six symptoms followed similar patterns. For three of the six symptoms (lack of energy, feeling drowsy, and worrying), all three dimensions changed over time. For the other three symptoms (difficulty sleeping, sweats, and pain), no changes over time occurred for any of the symptom dimensions. The overall effect of the five covariates was to increase symptom burden across all three dimensions. CONCLUSION: Findings from this study provide a more complete picture of the symptom experience of women who undergo RT for breast cancer. These findings can be used to identify patients at higher risk for more severe symptoms before, during, and after RT.
    No preview · Article · Sep 2012 · Journal of pain and symptom management
Show more