RTI Health Solutions, Research Triangle Park, Durham, NC, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Psychooncology. 2018 Mar;27(3):1050-1056. doi: 10.1002/pon.4595. Epub 2017 Dec 19.
To identify patient characteristics associated with sleep disturbance and worsening of sleep in individuals diagnosed with localized colorectal cancer and assess heterogeneity in these relationships.
Data were from the MY-Health study, a community-based observational study of adults diagnosed with cancer. Patient-Reported Outcomes Measurement Information System® Sleep Disturbance, Anxiety, Depression, Fatigue, and Pain Interference measures were administered. Participants self-reported demographics, comorbidities, and treatment information. Regression mixture and multiple regression models were used to evaluate the relationship between sleep disturbance and patient characteristics cross-sectionally at an average of 10 months after diagnosis (n = 613) as well as change in sleep disturbance over a 6-month period (n = 361).
Pain, anxiety, fatigue, and the existence of multiple comorbid conditions had statistically significant relationships with sleep disturbance (B = 0.09, 0.22, 0.29, and 1.53, respectively; P < 0.05). Retirement (B = -2.49) was associated with sleep quality in the cross-sectional model. Worsening anxiety (B = 0.14) and fatigue (B = 0.20) were associated with worsening sleep disturbance, and more severe sleep disturbance 10 months after diagnosis (B = -0.21) was associated with improvement in sleep quality after diagnosis (P < 0.05). No evidence of latent subgroups of patients (heterogeneity) was present.
Pain, anxiety, fatigue, employment, and comorbid conditions were associated with sleep disturbance, but regression coefficients were small (< |2.5|). Results suggest that screening for anxiety, depression, fatigue, or pain is not sufficient for identifying sleep disturbance. Given the negative consequences of sleep disturbance, sleep disturbance screening may be warranted.
确定与局部结直肠癌患者睡眠障碍和睡眠恶化相关的患者特征，并评估这些关系的异质性。
数据来自 MY-Health 研究，这是一项针对癌症患者的基于社区的观察性研究。采用患者报告的结局测量信息系统®睡眠障碍、焦虑、抑郁、疲劳和疼痛干扰措施进行评估。参与者自我报告人口统计学、合并症和治疗信息。回归混合和多元回归模型用于评估诊断后平均 10 个月（n=613）时睡眠障碍与患者特征之间的横断面关系，以及 6 个月期间睡眠障碍的变化（n=361）。
疼痛、焦虑、疲劳和多种合并症的存在与睡眠障碍具有统计学显著关系（B=0.09、0.22、0.29 和 1.53，分别；P<0.05）。退休（B=-2.49）与横断面模型中的睡眠质量相关。焦虑恶化（B=0.14）和疲劳恶化（B=0.20）与睡眠障碍恶化相关，诊断后 10 个月时更严重的睡眠障碍（B=-0.21）与诊断后睡眠质量的改善相关（P<0.05）。没有证据表明存在患者潜在亚组（异质性）。
疼痛、焦虑、疲劳、就业和合并症与睡眠障碍相关，但回归系数较小（< |2.5|）。结果表明，筛查焦虑、抑郁、疲劳或疼痛不足以识别睡眠障碍。鉴于睡眠障碍的负面后果，可能需要进行睡眠障碍筛查。
