Sleep disturbance and decrements in morning energy contribute to a higher symptom burden in oncology patients

• Published in: Sleep medicine 2023-08, Vol.108, p.124-136
• Main Authors: Davis, Jasna Krupalija, Mark, Sueann, Mackin, Lynda, Paul, Steven M., Cooper, Bruce A., Conley, Yvette P., Hammer, Marilyn J., Levine, Jon D., Miaskowski, Christine
• Format: Article
• Language: English
• Subjects: Cancer; Chemotherapy; Depression; Energy; Fatigue; Insomnia; Pain; Quality of life; Sleep disturbance
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2023.06.004

An emerging area of research is the relationship between sleep disturbance and decrements in energy. Given the paucity of research on the co-occurrence of these two symptoms, study purposes were to identify subgroups of oncology patients with distinct joint sleep disturbance AND morning energy profiles and evaluate for differences among the subgroups in demographic, clinical, and sleep disturbance characteristics, as well as the severity of other common symptoms and QOL outcomes. Patients (n = 1336) completed measures of sleep disturbance and energy 6 times over two cycles of chemotherapy. All of the other measures were completed at enrollment. Latent profile analysis was used to identify the distinct joint sleep disturbance and morning energy profiles. Three distinct profiles were identified (i.e., Low Sleep Disturbance and High Morning Energy (Normal, 20.6%), Moderate Sleep Disturbance and Low Morning Energy (Moderately Severe, 52.1%), Very High Sleep Disturbance and Very Low Morning Energy (Very Severe, 27.3%). Compared to Normal class, other two classes were more likely to be female, less likely to be employed, and had higher comorbidity burden and poorer functional status. Symptom scores and QOL outcomes exhibited a dose response effect (i.e., as the profile worsened, symptom scores increased and QOL scores decreased). Given the associations between sleep disturbance and decrements in energy and a higher symptom burden, poorer QOL outcomes, and increased mortality, assessment of these two symptoms needs to be a high priority for clinicians and appropriate interventions initiated. •80% of patients had high levels of sleep disturbance and decrements in morning energy.•Worst profiles had a higher symptom burden.•Worst profiles had poorer quality of life outcomes.