Zhou Eric S, Recklitis Christopher J
Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.
Support Care Cancer. 2014 Nov;22(11):3061-9. doi: 10.1007/s00520-014-2316-y. Epub 2014 Jun 17.
Insomnia is a common problem affecting cancer survivors even years after completion of therapy. Childhood cancer survivors may be at particular risk due to vulnerability to the effects of treatment and medical late effects which impact normal sleep development. Using an indicator of clinically significant insomnia (sleep efficiency), we examined a group of adult survivors of childhood cancer to (1) describe clinical insomnia rates, (2) identify physical and psychological correlates of insomnia, and (3) investigate the frequency with which sleep issues were evaluated during a cancer survivorship medical visit.
A total of 122 adult survivors of childhood cancer completed standard measures of sleep, psychological distress, and health-related quality of life. Medical records of the 75 survivors with a survivorship medical visit on the day of self-report measure completion were reviewed for documentation of sleep-related issues.
Twenty-eight percent of participants endorsed sleep efficiency below 85 %, indicating clinically significant insomnia. Insomnia was associated with poor physical health and anxiety but not with demographic or cancer treatment variables. Medical providers failed to document sleep in visit notes for 67 % of patients with self-reported insomnia.
A significant proportion of adult survivors of childhood cancer report insomnia, which is associated with physical and psychological health. Few survivors with insomnia discuss this issue with oncology providers during survivorship care. There is a clear need to screen for insomnia in this population. Patients and providers should take greater responsibility for discussing sleep issues and seeking out proper treatment referrals when it is identified.
失眠是一个常见问题，即使在癌症治疗结束数年之后仍会影响癌症幸存者。儿童癌症幸存者可能面临特别的风险，因为他们易受治疗影响以及医疗迟发效应的影响，而这些会影响正常的睡眠发育。我们使用临床显著失眠的一个指标（睡眠效率），对一组儿童癌症成年幸存者进行了研究，以（1）描述临床失眠率，（2）确定失眠的身体和心理相关因素，以及（3）调查在癌症幸存者医疗就诊期间评估睡眠问题的频率。
共有122名儿童癌症成年幸存者完成了睡眠、心理困扰及与健康相关生活质量的标准测量。对在自我报告测量完成当天进行了幸存者医疗就诊的75名幸存者的病历进行审查，以查看与睡眠相关问题的记录。
28%的参与者认可睡眠效率低于85%，表明存在临床显著失眠。失眠与身体健康不佳和焦虑相关，但与人口统计学或癌症治疗变量无关。对于67%自我报告有失眠的患者，医疗服务提供者在就诊记录中未记录睡眠情况。
相当一部分儿童癌症成年幸存者报告有失眠，这与身心健康相关。很少有失眠的幸存者在生存护理期间与肿瘤学服务提供者讨论这个问题。显然有必要在这一人群中筛查失眠。患者和服务提供者在识别出睡眠问题时，应更负责地讨论睡眠问题并寻求适当的治疗转诊。
