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New-onset insomnia among cancer patients undergoing chemotherapy: prevalence, risk factors, and its correlation with other symptoms

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Abstract

Study objectives

Although insomnia is common among cancer patients, its prevalence remains variable, and its risk factors and correlation with other cancer-related symptoms are not fully explored in the literature. This study aims to determine the prevalence and severity of insomnia as well as risk factors and sleep-related symptom clusters in a sample of cancer patients.

Methods

A cross-sectional survey was conducted collecting data from 213 cancer patients undergoing chemotherapy (age = 53.1 ± 11.3 years, 60% female). Insomnia was measured using the Insomnia Severity Index, a sleep log, and Actigraph, while symptoms were assessed using the Memorial Symptom Assessment Scale and the Hospital Anxiety and Depression Scale. Quality of life was measured with the Functional Assessment of Cancer Therapy—General.

Results

Of the participants, 42.8% reported insomnia, with 31.9% of those with insomnia reporting severe insomnia. Insomnia occurrence and severity were not correlated with the participants’ characteristics, cancer-related or treatment-related factors, only with the participants’ anxiety/depression scores. Principal component analysis showed that insomnia, depression, and anxiety formed a symptom cluster (p < 0.001). There was no difference between sleep parameters measured by Actigraphy in insomnia and non-insomnia participants.

Conclusion

This study demonstrated that the prevalence of insomnia was high and indicated a symptom cluster of insomnia, depression, and anxiety. Therefore, interventions to reduce this symptom cluster may benefit cancer patients who are trying to manage these symptoms.

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Acknowledgments

We would like to thank all the participants for their voluntary contribution to the study. We would like to thank Dr. Nguyen Thi Hoai Nga, Dr. Le Thanh Duc, Dr. Nguyen Trung Kien, Ms. Quach Thi Viet Huong, and Ms. Le Thi Tuyen from Vietnam national Cancer Hospital; Mr. Nguyen Cong Binh, Dr. Le Thi Le Quyen, Dr. Nguyen Trong Hieu, Dr. Le Thu Ha, Ms. Nguyen Phuong Thao, and Ms. Nguyen Hong Van from Hanoi Oncology Hospital; Prof. Mai Trong Khoa and Dr. Nguyen Van Thai from The Nuclear Medicine and Oncology Center of Bach Mai hospital for their great assistant during the data collection. We are also thankful to Dr. Paul Lee from the School of Nursing, The Hong Kong Polytechnic University for providing the Actigraph devices and helping us analyze data from Actigraph.

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Authors and Affiliations

  1. School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong SAR

    Huong Thi Xuan Hoang, Alex Molassiotis & Choi Wan Chan

  2. Faculty of Nursing, Phenikaa University, Hanoi, Vietnam

    Huong Thi Xuan Hoang & Van Liep Nguyen

  3. Hanoi Medical College, Hanoi, Vietnam

    Thi Huong Nguyen

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Corresponding author

Correspondence to Alex Molassiotis.

Ethics declarations

The study obtained ethical approval from the Human Subject Ethics Board, The Hong Kong Polytechnic University (Hong Kong SAR), and Hanoi School of Public Health (Vietnam).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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The institutions where work was performed:

1. Vietnam National Cancer Hospital, 43 Quan Su St., Hoan Kiem district, Hanoi, Vietnam

2. Bach Mai Hospital, 78 Giai Phong St., Dong Da district, Hanoi, Vietnam

3. Hanoi Oncology Hospital, 42A Thanh Nhan, Hanoi, Vietnam

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Hoang, H.T.X., Molassiotis, A., Chan, C.W. et al. New-onset insomnia among cancer patients undergoing chemotherapy: prevalence, risk factors, and its correlation with other symptoms. Sleep Breath 24, 241–251 (2020). https://doi.org/10.1007/s11325-019-01839-x

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