Abstract
Purpose
Insomnia is highly prevalent in people who are affected by cancer. However, options available to receive support for insomnia are limited. Telephone-based help services, such as cancer helplines, may be ideally placed to meet unmet needs regarding insomnia after cancer. The present study describes the prevalence and predictors of insomnia in patients and caregivers who call cancer helplines seeking support.
Methods
Participants (N = 500 patients, N = 234 caregivers) were recruited through an Australian state-based telephone-delivered cancer helpline. In addition to routine screening with the Distress Thermometer, participants were administered the Insomnia Severity Index.
Results
Most participants were female, older than 50 years of age, and were three (caregivers) to four (patients) months post-diagnosis. Insomnia symptoms were reported by 59.4 % of patients and 62.9 % of caregivers, with moderate to severe levels of insomnia reported by 27 % of patients and 30 % of caregivers. Insomnia was predicted by distress level for both patients (β = .31, p < .001) and caregivers (β = .32, p < .001) and age for patients only (β = −.13, p < .01).
Conclusions
Insomnia symptoms are common in patients and caregivers who call cancer helplines and appear to be related to distress. Telephone-based helplines have the potential to act as the first line of support in a stepped care approach addressing insomnia.
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References
Ancoli-Israel S (2009) Recognition and treatment of sleep disturbances in cancer. J Clin Oncol 27:5864–5866
Bastien CH, Vallières A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2:297–307
Beesley VL, Price MA, Webb PM, O'Rourke P, Marquart L, Australian Ovarian Cancer Study Group, Investigators AOCSQoLS (2013) Changes in supportive care needs after first-line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs. Psycho-Oncol 22:1565–1571
Berger AM, Sankaranarayanan J, Watanabe-Galloway S (2007) Current methodological approaches to the study of sleep disturbances and quality of life in adults with cancer: a systematic review. Psycho-Oncol 16:401–420
Bin YS, Marshall NS, Glozier N (2012) The burden of insomnia on individual function and healthcare consumption in Australia. Aust NZ J Publ Heal 36:462–468
Bright MA (2007) The national cancer institute’s cancer information service: a premiere cancer information and education resource for the nation. J Cancer Educ 22S:S2–S7
Carney S, Koetters T, Cho M, West C, Paul SM, Dunn L, Aouizerat BE, Dodd M, Copper B, Lee K, Wara W, Swift P, Miaskowski C (2011) Differences in sleep disturbance parameters between oncology outpatients and their family caregivers. J Clin Oncol 29:1001–1006
Chambers SK, Girgis A, Occhipinti S, Hutchison S, Turner J, Morris BA, Dunn J (2012) Psychological distress and unmet supportive care needs in cancer patients and carers who contact cancer helplines. Eur J Cancer Care 21:213–223
Couzi RJ, Helzlsouer KJ, Fetting JH (1995) Prevalence of menopausal symptoms among women with a history of breast cancer and attitudes toward estrogen replacement therapy. J Clin Oncol 13:2737–2744
Daley M, Morin CM, LeBlanc M, Grégoire J, Savard J (2009) The economic burden of insomnia: direct and indirect costs for individuals with insomnia syndrome, insomnia symptoms, and good sleepers. Sleep 32:55–64
Ekberg K, McDermott J, Moynihan C, Brindle L, Little P, Leydon GM (2014) The role of helplines in cancer care: intertwining emotional support with information or advice seeking needs J Psychsoc Onc
Finney Rutten LJ, Arora NK, Bakos AD, Aziz N, Rowland J (2005) Information needs and sources of information among cancer patients: a systematic review of research (1980–2003). Patient Educ Couns 57:250–261
Girgis A, Lambert SD, McElduff P, Bonevski B, Lecathelinais C, Boyes A, Stacey F (2013) Some things change, some things stay the same: a longitudinal analysis of cancer caregivers’ unmet supportive care needs. Psycho-Oncol 22:1557–1564
Hauri P, Wisbey J (1992) Wrist actigraphy in insomnia. Sleep 15:293–301
Hawkes AL, Hughes KL, Hutchison SD, Chambers SK (2010) Feasibility of brief psychological distress screening by a community-based telephone helpline for cancer patients and carers. BMC Cancer 10:14
Hutchison S, Sargeant H, Morris BA, Hawkes A, Clutton S, Chambers S (2011) A community-based approach to cancer counselling for patients and carers: a preliminary study. Psycho-Oncol 20:897–901
Hutchison SD, Steginga SK, Dunn J (2006) The tiered model of psychosocial intervention in cancer: community based approach. Psycho-Oncol 15:541–546
Jacobsen PB, Donovan KA, Trask PC, Fleishman SB, Zabora J, Baker F, Holland JC (2005) Screening for psychologic distress in ambulatory cancer patients. Cancer 103:1494–1502
Kvale EA, Shuster JL (2006) Sleep disturbance in supportive care of cancer: a review. J Palliat Med 9:437–450
Langford DJ, Lee K, Miaskowski C (2012) Sleep disturbance interventions in oncology patients and family caregivers: a comprehensive review and meta-analysis. Sleep Med Rev 16:397–414
Morin CM (1993) Insomnia: psychological assessment and management. Guilford, New York
Morin CM, Barlow DH, Dement WC (1993) Insomnia: psychological assessment and management. Guilford, New York
Morra ME, Thomsen C, Vezina A, Akkerman D, Bright MA, Dickens C, Hill DJ, Jefford M (2007) The international cancer information service: a worldwide resource. J Cancer Educ 22:S61–S69
National Comprehensive Cancer Network (2002) Practice guidelines in oncology—V.1.2002: distress management (Rep. No. Version 1). In: Editor (ed)^(eds) Book Practice Guidelines in Oncology- V.1.2002: Distress Management (Rep. No. Version 1), City
Osoba D, Zee B, Warr D, Latreille J, Kaizer L, Pater J (1997) Effect of postchemotherapy nausea and vomiting on health-related quality of life. Support Care Cancer 5:307–313
Ritterband LM, Bailey ET, Thorndike FP, Lord HR, Farrell-Carnahan L, Baum LD (2012) Initial evaluation of an Internet intervention to improve the sleep of cancer survivors with insomnia. Psycho-Oncol 21:695–705
Savard J, Ivers H, Villa J, Caplette-Gingras A, Morin CM (2011) Natural course of insomnia comorbid with cancer: an 18-month longitudinal study. J Clin Oncol 29:3580–3586
Savard J, Savard M (2013) Insomnia and cancer: prevalence, nature, and nonpharmacologic treatment. Sleep Med Clin 8:373–387
Savard M-H, Savard J, Simard S, Ivers H (2005) Empirical validation of the Insomnia Severity Index in cancer patients. Psycho-Oncol 14:429–441
Swash B, Hulbert-Williams N, Bramwell R (2014) Unmet psychosocial needs in haematological cancer: a systematic review. Support Care Cancer 22:1131–1141
Vargas S, Antoni MH, Carver CS, Lechner SC, Wohlgemuth W, Llabre M, Blomberg BB, Glück S, DerHagopian RP (2013) Sleep quality and fatigue after a stress management intervention for women with early-stage breast cancer in southern Florida international. J Behav Med :1–11
Acknowledgments
Prof. Chambers is supported by the Australian Research Council Future Fellowship. We gratefully acknowledge the support of Robert McDowall for his assistance with data analysis.
Conflict of interest
Dr Morris, Prof. Glozier, Prof. Dunn and Prof Chambers have no conflict of interest. Prof. Chambers has full control of all the primary data and agrees to allow the journal to review it on request. Drs. Ritterband and Thorndike have equity ownership in BeHealth Solutions, LLC, a company disseminating online interventions, including one for insomnia. The terms of Drs. Ritterband and Thorndike’s arrangement with BeHealth Solutions have been reviewed and approved by the University of Virginia in accordance with its conflict of interest policy.
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Morris, B.A., Thorndike, F.P., Ritterband, L.M. et al. Sleep disturbance in cancer patients and caregivers who contact telephone-based help services. Support Care Cancer 23, 1113–1120 (2015). https://doi.org/10.1007/s00520-014-2458-y
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DOI: https://doi.org/10.1007/s00520-014-2458-y