Systematic review of sleep and sleep disorders among prostate cancer patients and caregivers: a call to action for using validated sleep assessments during prostate cancer care

• Published in: Sleep medicine 2022-06, Vol.94, p.38-53
• Main Authors: Robbins, Rebecca, Cole, Renee, Ejikeme, Chidera, Orstad, Stephanie L., Porten, Sima, Salter, Carolyn A., Sanchez Nolasco, Tatiana, Vieira, Dorice, Loeb, Stacy
• Format: Article
• Language: English
• Subjects: And tertiary care; Caregiver; Caregivers - psychology; Humans; Improved individual outcomes; Individualized patient profile; Male; Primary; Prostate cancer; Prostatic Neoplasms - complications; Prostatic Neoplasms - therapy; Quality of Life; Secondary; Sleep; Sleep health; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders - etiology; Urology
• ISSN: 1389-9457; 1878-5506; 1878-5506
• DOI: 10.1016/j.sleep.2022.03.020

To examine the impact of prostate cancer (PCa) on sleep health for patients and caregivers. We hypothesized that sleep disturbances and poor sleep quality would be prevalent among patients with PCa and their caregivers. A systematic literature search was conducted according to the Preferred Reporting Items for a Systematic Review and Meta-analysis guidelines. To be eligible for this systematic review, studies had to include: (1) patients diagnosed with PCa and/or their caregivers; and (2) objective or subjective data on sleep. 2431 articles were identified from the search. After duplicates were removed, 1577 abstracts were screened for eligibility, and 315 underwent full-text review. Overall, 83 articles met inclusion criteria and were included in the qualitative synthesis. The majority of papers included patients with PCa (98%), who varied widely in their treatment stage. Only 3 studies reported on sleep among caregivers of patients with PCa. Most studies were designed to address a different issue and examined sleep as a secondary endpoint. Commonly used instruments included the Insomnia Severity Index and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaires (EORTC-QLQ). Overall, patients with PCa reported a variety of sleep issues, including insomnia and general sleep difficulties. Both physical and psychological barriers to sleep are reported in this population. There was common use of hypnotic medications, yet few studies of behavioral interventions to improve sleep for patients with PCa or their caregivers. Many different sleep issues are reported by patients with PCa and caregivers with diverse sleep measurement methods and surveys. Future research may develop consensus on validated sleep assessment tools for use in PCa clinical care and research to promote facilitate comparison of sleep across PCa treatment stages. Also, future research is needed on behavioral interventions to improve sleep among this population. •Sleep problems are common among cancer patients and caregivers and adversely impact quality of life.•We conducted a systematic review of the literature on sleep and quality of life among prostate cancer patients and their caregivers.•Sleep problems were common among survivors and caregivers, the prevalence of which ranged widely across different populations and treatment stages.•Scant literature has developed or evaluated the impact of interventions to improve sleep among prostate cancer survivors