The Relation of Trouble Sleeping, Depressed Mood, Pain, and Fatigue in Patients with Cancer

Overview

Journal J Clin Sleep Med

Specialties Neurology
Psychiatry

Date 2009 Dec 9

PMID 19968046

Citations 49

Authors

Edward J Stepanski

Mark S Walker

Lee S Schwartzberg

L Johnetta Blakely

Jason C Ong

Arthur C Houts

Affiliations

Soon will be listed here.

Abstract

Study Objectives: To evaluate the relation among several symptoms that occur commonly in cancer patients: trouble sleeping, fatigue/sleepiness, depressed mood, and pain in a large cohort of cancer patients undergoing treatment in a community oncology practice.

Methods: Demographic, clinical, and patient reported outcomes data from 11,445 cancer patients undergoing treatment in a large community oncology practice were analyzed using structural equation modeling. The data were split so that a model was constructed using half of the patients; this model was then cross-validated on the remaining patients.

Results: Fatigue was best represented as a latent variable, and significant direct effects were found for trouble sleeping, depressed mood, and pain. Also, there were significant indirect effects of these variables on fatigue. The effect of depressed mood on fatigue and pain was mediated by trouble sleeping, and the effect of trouble sleeping on fatigue was mediated by pain.

Conclusions: These results predict that interventions aimed at treatment of trouble sleeping, depressed mood, and pain will improve fatigue in patients with cancer. Further, these data predict that treatment of trouble sleeping will improve pain management in this population.

Citing Articles

Proposal for Managing Cancer-Related Insomnia: A Systematic Literature Review of Associated Factors and a Narrative Review of Treatment.

Saeki Y, Sumi Y, Ozaki Y, Hosonaga M, Kenmotsu Y, Onoe T Cancer Med. 2024; 13(22):e70365.

PMID: 39584650 PMC: 11586868. DOI: 10.1002/cam4.70365.

Real-world patient experience with medicinal cannabis use for symptom management in an Australian advanced cancer setting: a mixed method, cohort study using the theory of planned behaviour framework.

Ong J, Lo U, Musa H, Li J, Gaon J, Lacey J Support Care Cancer. 2024; 32(12):795.

PMID: 39546029 PMC: 11567999. DOI: 10.1007/s00520-024-09013-0.

Prediction of Cancer Symptom Trajectory Using Longitudinal Electronic Health Record Data and Long Short-Term Memory Neural Network.

Chae S, Street W, Ramaraju N, Gilbertson-White S JCO Clin Cancer Inform. 2024; 8:e2300039.

PMID: 38471054 PMC: 10948138. DOI: 10.1200/CCI.23.00039.

The Behavioral Adaptations and Barriers of Patients Employing Non-Pharmacological Strategies for Cancer Pain Management-A Qualitative Study.

Liu M, Liang S, Chao T, Tseng L, Rosenberg J Healthcare (Basel). 2023; 11(22).

PMID: 37998403 PMC: 10671318. DOI: 10.3390/healthcare11222911.

Psychoneurological symptoms and inflammatory markers in patients with glioma in China: a network analysis.

Li H, Shi X, Li J, Zhang X, Li F Support Care Cancer. 2023; 31(7):435.

PMID: 37395813 DOI: 10.1007/s00520-023-07873-6.

References

Fortner B, Okon T, Schwartzberg L, Tauer K, Houts A . The Cancer Care Monitor: psychometric content evaluation and pilot testing of a computer administered system for symptom screening and quality of life in adult cancer patients. J Pain Symptom Manage. 2003; 26(6):1077-92. DOI: 10.1016/j.jpainsymman.2003.04.003. View

Zammit G, Weiner J, DAmato N, Sillup G, McMillan C . Quality of life in people with insomnia. Sleep. 1999; 22 Suppl 2:S379-85. View

Shen J, Barbera J, Shapiro C . Distinguishing sleepiness and fatigue: focus on definition and measurement. Sleep Med Rev. 2005; 10(1):63-76. DOI: 10.1016/j.smrv.2005.05.004. View

Cleeland C, Mendoza T, Wang X, Chou C, Harle M, Morrissey M . Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory. Cancer. 2000; 89(7):1634-46. DOI: 10.1002/1097-0142(20001001)89:7<1634::aid-cncr29>3.0.co;2-v. View

Piperidou C, Karlovasitou A, Triantafyllou N, Terzoudi A, Constantinidis T, Vadikolias K . Influence of sleep disturbance on quality of life of patients with epilepsy. Seizure. 2008; 17(7):588-94. DOI: 10.1016/j.seizure.2008.02.005. View

Patrick D, Ferketich S, Frame P, Harris J, Hendricks C, Levin B . National Institutes of Health State-of-the-Science Conference Statement: Symptom Management in Cancer: Pain, Depression, and Fatigue, July 15-17, 2002. J Natl Cancer Inst. 2003; 95(15):1110-7. DOI: 10.1093/jnci/djg014. View

Smith M, Haythornthwaite J . How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004; 8(2):119-32. DOI: 10.1016/S1087-0792(03)00044-3. View

Cohen S, Patel S, Khetpal P, Peterson R, Kimmel P . Pain, sleep disturbance, and quality of life in patients with chronic kidney disease. Clin J Am Soc Nephrol. 2007; 2(5):919-25. DOI: 10.2215/CJN.00820207. View

Hoffman A, Given B, von Eye A, Gift A, Given C . Relationships among pain, fatigue, insomnia, and gender in persons with lung cancer. Oncol Nurs Forum. 2007; 34(4):785-92. DOI: 10.1188/07.ONF.785-792. View

10.

Fortner B, Baldwin S, Schwartzberg L, Houts A . Validation of the Cancer Care Monitor items for physical symptoms and treatment side effects using expert oncology nurse evaluation. J Pain Symptom Manage. 2006; 31(3):207-14. DOI: 10.1016/j.jpainsymman.2005.07.009. View

11.

Miaskowski C, Aouizerat B, Dodd M, Cooper B . Conceptual issues in symptom clusters research and their implications for quality-of-life assessment in patients with cancer. J Natl Cancer Inst Monogr. 2007; (37):39-46. DOI: 10.1093/jncimonographs/lgm003. View

12.

Buysse D, Angst J, Gamma A, Ajdacic V, Eich D, Rossler W . Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep. 2008; 31(4):473-80. PMC: 2279748. DOI: 10.1093/sleep/31.4.473. View

13.

Miaskowski C, Cooper B, Paul S, Dodd M, Lee K, Aouizerat B . Subgroups of patients with cancer with different symptom experiences and quality-of-life outcomes: a cluster analysis. Oncol Nurs Forum. 2006; 33(5):E79-89. DOI: 10.1188/06.ONF.E79-E89. View

14.

Barsevick A . The elusive concept of the symptom cluster. Oncol Nurs Forum. 2007; 34(5):971-80. DOI: 10.1188/07.ONF.971-980. View

15.

Savard J, Simard S, Blanchet J, Ivers H, Morin C . Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep. 2001; 24(5):583-90. DOI: 10.1093/sleep/24.5.583. View

16.

Roehrs T, Hyde M, Blaisdell B, Greenwald M, Roth T . Sleep loss and REM sleep loss are hyperalgesic. Sleep. 2006; 29(2):145-51. DOI: 10.1093/sleep/29.2.145. View

17.

Drewes A, Nielsen K, Arendt-Nielsen L, Hansen L . The effect of cutaneous and deep pain on the electroencephalogram during sleep--an experimental study. Sleep. 1997; 20(8):632-40. DOI: 10.1093/sleep/20.8.632. View

18.

Koopman C, Nouriani B, Erickson V, Anupindi R, Butler L, Bachmann M . Sleep disturbances in women with metastatic breast cancer. Breast J. 2002; 8(6):362-70. DOI: 10.1046/j.1524-4741.2002.08606.x. View

19.

Fox S, Lyon D . Symptom clusters and quality of life in survivors of lung cancer. Oncol Nurs Forum. 2006; 33(5):931-6. DOI: 10.1188/06.ONF.931-936. View

20.

Parker K, Bliwise D, Ribeiro M, Jain S, Vena C, Kohles-Baker M . Sleep/Wake patterns of individuals with advanced cancer measured by ambulatory polysomnography. J Clin Oncol. 2008; 26(15):2464-72. DOI: 10.1200/JCO.2007.12.2135. View