Daniel Lauren C, Aggarwal Richa, Schwartz Lisa A
1 Department of Psychology, Rutgers University-Camden , Camden, New Jersey.
2 Division of Oncology, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.
J Adolesc Young Adult Oncol. 2017 Dec;6(4):560-567. doi: 10.1089/jayao.2017.0006. Epub 2017 Jun 19.
Adolescents and young adults (AYA) with cancer are a vulnerable group facing more intense treatments, higher symptom burden, and poorer treatment outcomes relative to younger children. Sleep disruption is common during cancer treatment and sleep problems persist into adulthood for some survivors of AYA cancer. The developmental period of adolescence/emerging adulthood confers greater biological and behavioral risk for insufficient sleep relative to older or younger ages. Thus, understanding AYA sleep disturbances shortly after completing treatment can inform interventions to manage cancer-related symptoms and improve quality of life.
Sixty-one AYA (ages 12-25) within 1 year of finishing cancer treatment completed the Pittsburgh Sleep Quality Index (PSQI) and the Minneapolis-Manchester Quality of Life Instrument-Adolescent Form. Treatment variables were extracted from electronic medical records.
Forty-seven percent of participants were classified as "poor sleepers," 41% reported prolonged sleep onset latency (>30 minutes), 31% reported sleep efficiency suggestive of insomnia, and 33% slept <8 hours nightly. Age moderated the relationship between time off treatment and PSQI total score: for younger AYA the relationship was positive and for older AYA the relationship was negative. Better sleep and higher quality of life were strongly related (r = -0.57, p < 0.001).
For almost half of AYA cancer survivors studied, sleep is disrupted as indicated by long sleep-onset latencies, sleep efficiency suggestive of insomnia, and inadequate total sleep time. Screening for sleep disturbances after AYA complete cancer therapy may reduce the impact of sleep on quality of life and identify those at risk for insomnia.
与年幼儿童相比,患有癌症的青少年和青年成人(AYA)是一个弱势群体,面临更强化的治疗、更高的症状负担和更差的治疗结果。睡眠中断在癌症治疗期间很常见,并且一些AYA癌症幸存者的睡眠问题会持续到成年期。相对于年长者或年幼者,青春期/成年早期的发育阶段会带来更高的生物和行为风险,导致睡眠不足。因此,了解AYA在完成治疗后不久的睡眠障碍情况可为管理癌症相关症状和改善生活质量的干预措施提供依据。
61名在完成癌症治疗后1年内的AYA(年龄12 - 25岁)完成了匹兹堡睡眠质量指数(PSQI)和明尼阿波利斯 - 曼彻斯特青少年生活质量量表。治疗变量从电子病历中提取。
47%的参与者被归类为“睡眠不佳者”,41%报告入睡潜伏期延长(>30分钟),31%报告睡眠效率提示失眠,33%每晚睡眠不足8小时。年龄调节了治疗结束时间与PSQI总分之间的关系:对于较年轻的AYA,这种关系是正相关,而对于较年长 的AYA,这种关系是负相关。更好的睡眠与更高的生活质量密切相关(r = -0.57,p < 0.001)。
在所研究的几乎一半的AYA癌症幸存者中,睡眠受到干扰,表现为入睡潜伏期长、睡眠效率提示失眠以及总睡眠时间不足。在AYA完成癌症治疗后筛查睡眠障碍可能会减少睡眠对生活质量的影响,并识别出有失眠风险的人群。