Page Jessica M, Morgans Alicia K, Hassett Michael J, Haakenstad Ellana, Manni Michael, McCleary Nadine J, Zhou Eric S
Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA.
Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA.
Psychooncology. 2025 Jan;34(1):e70079. doi: 10.1002/pon.70079.
Insomnia is the most common sleep disturbance among cancer patients undergoing active treatment. If untreated, it is associated with significant physical and psychological health consequences. Prior efforts to determine insomnia prevalence and correlates have primarily assessed patients in clinical trials, in limited disease groups, and excluding important patient subgroups. These findings are likely to be influenced by research participation effects, which could bias outcomes. We sought to address these limitations in a large, real-world sample.
Between 2018 and 2021, all patients seen at our institution were offered an electronic patient-reported outcomes (PRO) questionnaire where they could self-report on a range of symptoms based on the National Cancer Institute's PRO-CTCAE. Medical records were abstracted for demographics and cancer diagnosis/treatment. We evaluated N = 9350 patients for whom there was complete data.
During cancer treatment, 21% of patients reported insomnia symptoms. Demographically, prevalence was higher in patients who were female (22% vs. 19%), younger than 60 years of age (22% vs. 20%), non-White (24% vs. 20%), and on public insurance (22% vs. 20%). Medically, patients undergoing palliative treatment were more likely to report insomnia symptoms, irrespective of cancer site (23% vs. 19%). The prevalence of insomnia symptoms ranged from 18% (genitourinary) to 23% (gastrointestinal).
More than 1 in 5 cancer patients suffer from symptoms of insomnia. It is important that oncologists and cancer centers routinely assess insomnia severity in their patients. Leveraging the use of existing patient-reported outcomes at an institution may be important to help with the identification of insomnia symptoms.
失眠是正在接受积极治疗的癌症患者中最常见的睡眠障碍。若不治疗，会对身心健康造成严重后果。此前确定失眠患病率及其相关因素的研究主要在临床试验中评估患者，疾病组有限，且排除了重要的患者亚组。这些研究结果可能受到研究参与效应的影响，从而导致结果出现偏差。我们试图在一个大型的真实世界样本中解决这些局限性。
2018年至2021年期间，我们机构接待的所有患者都收到了一份电子患者报告结局（PRO）问卷，他们可以根据美国国立癌症研究所的PRO-CTCAE自行报告一系列症状。提取病历中的人口统计学信息和癌症诊断/治疗信息。我们评估了9350例有完整数据的患者。
在癌症治疗期间，21%的患者报告有失眠症状。从人口统计学角度来看，女性患者（22%对19%）、年龄小于60岁的患者（22%对20%）、非白人患者（24%对20%）以及参加公共保险的患者（22%对20%）的失眠患病率更高。从医学角度来看，接受姑息治疗的患者更有可能报告失眠症状，无论癌症部位如何（23%对19%）。失眠症状的患病率从18%（泌尿生殖系统）到23%（胃肠道）不等。
超过五分之一的癌症患者患有失眠症状。肿瘤学家和癌症中心定期评估患者的失眠严重程度很重要。利用机构现有的患者报告结局可能有助于识别失眠症状。
