Abstract
Abstract only
e18651
Background: Insomnia is a prevalent, debilitating problem that is faced by a growing number of patients with cancer. These patients are at higher risk of excessive fatigue, anxiety, depression, less immunity and poor adherence to treatment. A recommendation by the National Comprehensive Cancer Network (NCCN) Guidelines is to routinely screen patients for sleeps issues. We sought to analyze the screening for insomnia and its management at a cancer center in Appalachia. We also evaluated referrals for cognitive behavioral therapy, which is recommended as first line therapy in patients with chronic insomnia by the American College of Physicians (ACP). Methods: We performed an anonymous survey related to sleep at our cancer center which included 312 patients diagnosed with a solid tumor malignancy divided into early stage (stage I or II) or advanced stage (stage III or IV). Three questions were directly from NCCN guidelines screening for sleep disturbances in patients with cancer. We also added questions regarding if the patients’ medical oncologists ever asked about or addressed their sleep difficulties and if any treatment was offered. The institutional review board of the cancer center approved this study. Results: Our results showed that 67.9% (212 patients) reported either having difficulty falling asleep, staying asleep, or waking up too early. 14.7% (46 patients) reported excessive sleepiness, while 64.7% (202 patients) reported that someone else told them that they snore frequently or stop breathing while sleeping. Of the patients who reported difficulty with sleep, only 4.7% (10 patients) reported that their medical oncologist ever addressed it, with 7 patients being started on medication. No patients were referred for cognitive behavioral therapy. Patients with advanced stage disease were four times more likely to report disturbances with sleep than early stage disease. Conclusions: Patients with cancer have difficulty with sleep, which profoundly affects their quality of life and may negatively impact their response to treatment. We wanted to use this survey to see how we can improve efforts to routinely screen patients and identify those in need of assistance and therapy. Routine screening and initiation of treatment must be implemented nationwide in all cancer centers. We aim to start referrals for cognitive behavioral therapy and continue to address patients’ sleep disturbances on a routine basis.