Angelina M M Santoso1, Femke Jansen2, Birgit I Lissenberg-Witte3, Robert J Baatenburg de Jong4, Johannes A Langendijk5, C René Leemans6, Johannes H Smit7, Robert P Takes8, Chris H J Terhaard9, Annemieke van Straten10, Irma M Verdonck-de Leeuw11. 1. Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands. 2. Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands. 3. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam, the Netherlands. 4. Department of Otolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. 5. Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. 6. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands. 7. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. 8. Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands. 9. Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands. 10. Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. 11. Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands. Electronic address: im.verdonck@amsterdamumc.nl.
Abstract
OBJECTIVES: Patients with head and neck cancer (HNC) often report disturbances in their sleep quality, impairing their quality of life. This study aims to examine the trajectories of sleep quality from diagnosis up to 6-month after treatment, as well as the pre-treatment risk factors for poor sleep trajectories. MATERIALS AND METHODS: Sleep quality (Pittsburgh sleep quality index) was measured shortly after diagnosis (pre-treatment), and at 3 and 6 months after finishing treatment. Patients were categorized into 5 trajectory groups. We examined the association of sleep quality trajectories with sociodemographic and clinical characteristics, coping style, HNC symptoms, and psychological distress. RESULTS: Among 412 included patients, about a half either had a persistent good sleep (37.6%) or an improving (16.5%) trajectory. About a third had a persistent poor sleep (21.8%) or worsening (10.9%) sleep trajectory. The remaining patients (13.1%), alternated between good and poor sleep. Using persistent good sleep as a reference outcome, persistent poor sleepers were more likely to be woman (odds ratio [OR] = 1.98, 95% confidence interval [CI] 1.01-3.90), use painkillers prior to treatment (OR = 2.52, 95% CI 1.33-4.77), and have more pre-treatment anxiety symptoms (OR = 1.26, 95% CI 1.15-1.38). CONCLUSION: Unfavorable sleep quality trajectories are prevalent among HNC patients from pre-treatment to 6-month after treatment. A periodic sleep evaluation starting shortly after HNC diagnosis is necessary to identify persistent sleep problems, especially among high-risk group.
OBJECTIVES:Patients with head and neck cancer (HNC) often report disturbances in their sleep quality, impairing their quality of life. This study aims to examine the trajectories of sleep quality from diagnosis up to 6-month after treatment, as well as the pre-treatment risk factors for poor sleep trajectories. MATERIALS AND METHODS: Sleep quality (Pittsburgh sleep quality index) was measured shortly after diagnosis (pre-treatment), and at 3 and 6 months after finishing treatment. Patients were categorized into 5 trajectory groups. We examined the association of sleep quality trajectories with sociodemographic and clinical characteristics, coping style, HNC symptoms, and psychological distress. RESULTS: Among 412 included patients, about a half either had a persistent good sleep (37.6%) or an improving (16.5%) trajectory. About a third had a persistent poor sleep (21.8%) or worsening (10.9%) sleep trajectory. The remaining patients (13.1%), alternated between good and poor sleep. Using persistent good sleep as a reference outcome, persistent poor sleepers were more likely to be woman (odds ratio [OR] = 1.98, 95% confidence interval [CI] 1.01-3.90), use painkillers prior to treatment (OR = 2.52, 95% CI 1.33-4.77), and have more pre-treatment anxiety symptoms (OR = 1.26, 95% CI 1.15-1.38). CONCLUSION: Unfavorable sleep quality trajectories are prevalent among HNC patients from pre-treatment to 6-month after treatment. A periodic sleep evaluation starting shortly after HNC diagnosis is necessary to identify persistent sleep problems, especially among high-risk group.
Authors: Femke Jansen; Ruud H Brakenhoff; Rob J Baatenburg de Jong; Johannes A Langendijk; C René Leemans; Robert P Takes; Chris H J Terhaard; Jan H Smit; Irma M Verdonck-de Leeuw Journal: BMC Med Res Methodol Date: 2022-01-22 Impact factor: 4.615