卵巢癌女性的失眠及其与生活质量的关系。

Insomnia and its association with quality of life in women with ovarian cancer.

机构信息

Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia; School of Public Health, The University of Queensland, Brisbane, Australia.

The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia.

出版信息

Gynecol Oncol. 2020 Sep;158(3):760-768. doi: 10.1016/j.ygyno.2020.06.500. Epub 2020 Jul 9.

DOI:10.1016/j.ygyno.2020.06.500

PMID:32653100

Abstract

OBJECTIVES

Insomnia is common in women with ovarian cancer but there are limited prospective data on the frequency and degree of impact on patients. Our objective was to determine the prevalence of insomnia over the first three years after a diagnosis of ovarian cancer; and the relationship between insomnia and quality of life.

METHODS

OPAL (Ovarian cancer, Prognosis And Lifestyle) is a prospective study of Australian women with epithelial ovarian cancer; 894 provided information on insomnia symptoms, medications and quality of life at three, six, nine, 12, 24 and 36 months after diagnosis. Generalised linear mixed models were used to determine the relationship between insomnia and quality of life measured at the same time and three months later.

RESULTS

One-quarter of women reported symptoms consistent with clinical insomnia within three years after diagnosis and an additional 13% regularly used sleep medication (total 36% affected). Excluding 7% who reported insomnia symptoms before diagnosis, 22% reported new insomnia, which reduced to 17% when also excluding women on chemotherapy. The proportion of women with clinical (14%) or subclinical (28%) insomnia symptoms was highest at three months after diagnosis. Compared to women with no insomnia, those with clinical insomnia had significantly lower quality of life measured at the same time (8.4 points lower, 95% CI: 7.2-9.5), and three months later (5.5 points lower, 95% CI: 3.4-7.6).

CONCLUSIONS

Over a third of women with ovarian cancer likely experience insomnia after diagnosis; this may persist and is associated with poorer quality of life.

摘要

目的

卵巢癌患者常伴有失眠，但关于其发病频率及其对患者影响程度的前瞻性数据有限。本研究旨在确定卵巢癌确诊后 3 年内失眠的发生率，并分析失眠与生活质量之间的关系。

方法

OPAL（卵巢癌、预后和生活方式）是一项澳大利亚女性上皮性卵巢癌的前瞻性研究；894 名女性在确诊后 3、6、9、12、24 和 36 个月时报告了失眠症状、药物使用和生活质量。采用广义线性混合模型来确定同时和 3 个月后失眠与生活质量之间的关系。

结果

四分之一的女性在确诊后 3 年内出现符合临床失眠标准的症状，另有 13%的女性定期使用睡眠药物（总共有 36%的女性受影响）。排除 7%在诊断前报告失眠症状的女性，22%的女性报告新出现失眠，当也排除正在接受化疗的女性时，这一比例降至 17%。在诊断后 3 个月时，有临床（14%）或亚临床（28%）失眠症状的女性比例最高。与无失眠的女性相比，有临床失眠的女性在同一时间（低 8.4 分，95%CI：7.2-9.5）和 3 个月后（低 5.5 分，95%CI：3.4-7.6）的生活质量显著降低。