Insomnia in adult survivors of childhood cancer: a report from project REACH
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Insomnia is a common problem affecting cancer survivors even years after completion of therapy. Childhood cancer survivors may be at particular risk due to vulnerability to the effects of treatment and medical late effects which impact normal sleep development. Using an indicator of clinically significant insomnia (sleep efficiency), we examined a group of adult survivors of childhood cancer to (1) describe clinical insomnia rates, (2) identify physical and psychological correlates of insomnia, and (3) investigate the frequency with which sleep issues were evaluated during a cancer survivorship medical visit.
A total of 122 adult survivors of childhood cancer completed standard measures of sleep, psychological distress, and health-related quality of life. Medical records of the 75 survivors with a survivorship medical visit on the day of self-report measure completion were reviewed for documentation of sleep-related issues.
Twenty-eight percent of participants endorsed sleep efficiency below 85 %, indicating clinically significant insomnia. Insomnia was associated with poor physical health and anxiety but not with demographic or cancer treatment variables. Medical providers failed to document sleep in visit notes for 67 % of patients with self-reported insomnia.
A significant proportion of adult survivors of childhood cancer report insomnia, which is associated with physical and psychological health. Few survivors with insomnia discuss this issue with oncology providers during survivorship care. There is a clear need to screen for insomnia in this population. Patients and providers should take greater responsibility for discussing sleep issues and seeking out proper treatment referrals when it is identified.
KeywordsInsomnia Sleep disorder Childhood cancer Cancer survivorship Quality of life
Conflict of interest
Eric S. Zhou and Christopher J. Recklitis declare that they have no conflicts of interest and no disclosures to declare.
- 23.Trudel-Fitzgerald C, Savard J, Ivers H. Which symptoms come first? Exploration of temporal relationships between cancer-related symptoms over an 18-month period. Annals of Behavioral Medicine, 2013: 1-9.Google Scholar
- 24.Institute NC. Follow-up care after cancer treatment. 2013 [cited 2013 November]; Available from: http://www.cancer.gov/cancertopics/factsheet/Therapy/followup
- 25.Johnson EO (1999) Sleep in America: 1999. Results from the National Sleep Foundations, WashingtonGoogle Scholar
- 28.Hoffman AJ, Given BA, Von Eye A, et al. (2007) Relationships among pain, fatigue, insomnia, and gender in persons with lung cancer. in Oncology nursing forum. . Onc Nurs SocietyGoogle Scholar
- 29.American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th Edition, Text Revision (DSM-IV-TR). 4th ed, Washington, DC: American Psychiatric AssociationGoogle Scholar
- 36.Derogatis LR (2001) BSI 18, Brief Symptom Inventory 18: Administration, Scoring and Procedure Manual. NCS Pearson, Incorporated, MinneapolisGoogle Scholar
- 44.Association AP (2013) Diagnostic and statistical manual of mental disorders. Vol. 5. American Psychiatric Publishing, ArlingtonGoogle Scholar
- 46.Landier W, Bhatia S, Eshelman DA et al (2004) Development of risk-based guidelines for pediatric cancer survivors: the Children’s Oncology Group Long-Term Follow-Up Guidelines from the Children’s Oncology Group Late Effects Committee and Nursing Discipline. J Clin Oncol 22(24):4979–4990PubMedCrossRefGoogle Scholar