Parker Kathy P, Bliwise Donald L, Ribeiro Maria, Jain Sanjay R, Vena Catherine I, Kohles-Baker Mary Kay, Rogatko Andre, Xu Zhiheng, Harris Wayne B
Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA 30322-4207, USA.
J Clin Oncol. 2008 May 20;26(15):2464-72. doi: 10.1200/JCO.2007.12.2135.
Sleep/wake disturbances are prevalent in patients with advanced cancer, but 24-hour polysomnography (PSG) examinations of these patterns have not been undertaken. The purpose of this study was to describe these sleep/wake patterns using continuous PSG and to explore relationships with selected demographic and clinical variables.
The sample included patients with advanced cancer (solid tumors); those with neurologic disorders or psychosis, substance abuse, or brain metastasis were excluded. The final sample included 114 participants with a mean age of 51.1 years (+/- 9.1 years). Participants underwent continuous, ambulatory PSG for 42 hours in their home environments. Standard PSG measures were calculated. Analysis included data from 2 nights and the intervening day. Descriptive statistics were used to summarize sleep/wake parameters of the average of the 2 nights and the intervening day. Nonparametric analyses were used to detect differences and relationships among the variables.
Compared with normative data, participants had reduced quantity and quality of nocturnal sleep and episodes of sleep scattered throughout the day. Increased daytime sleep was negatively associated with several key parameters of nocturnal sleep quantity and quality. Women, whites, and those who were married/partnered and had more education had better nocturnal sleep. Cancer type and selected medications may be risk factors for disturbed sleep and waking.
Participants experienced severe difficulty with "state maintenance", or the ability to maintain both the sleep and waking states. Research designed to identify the etiology of these problems is needed to develop effective interventions.
睡眠/觉醒障碍在晚期癌症患者中普遍存在，但尚未对这些模式进行24小时多导睡眠图（PSG）检查。本研究的目的是使用连续PSG描述这些睡眠/觉醒模式，并探讨与选定的人口统计学和临床变量之间的关系。
样本包括晚期癌症（实体瘤）患者；排除患有神经系统疾病或精神病、药物滥用或脑转移的患者。最终样本包括114名参与者，平均年龄为51.1岁（±9.1岁）。参与者在其家庭环境中接受了42小时的连续动态PSG检查。计算标准PSG指标。分析包括来自两个晚上和中间一天的数据。描述性统计用于总结两个晚上和中间一天平均值的睡眠/觉醒参数。非参数分析用于检测变量之间的差异和关系。
与标准数据相比，参与者夜间睡眠的数量和质量下降，且白天有分散的睡眠发作。白天睡眠增加与夜间睡眠数量和质量的几个关键参数呈负相关。女性、白人、已婚/有伴侣且受教育程度较高的人夜间睡眠较好。癌症类型和选定的药物可能是睡眠和觉醒障碍的危险因素。
参与者在“状态维持”方面遇到严重困难，即维持睡眠和觉醒状态的能力。需要开展旨在确定这些问题病因的研究，以制定有效的干预措施。
