Sleep Disruption Among Cancer Patients Following Autologous Hematopoietic Stem Cell Transplantation

摘要

Background: Sleep disruption is one of the most commonly reported quality of life concerns among cancer patients who have undergone hematopoietic stem cell transplantation (HSCT). Despite the high percentage of patients reporting sleep concerns, relatively little research has characterized sleep problems or explored relationships with psychological factors. In addition, no studies have used actigraph technology to characterize sleep issues among transplant recipients.;Method: Autologous HSCT recipients who were 6 to 18 months post-transplant were invited to participate. Patients completed self-report measures of cancer-related distress, fear of cancer recurrence, dysfunctional cognitions about sleep, and maladaptive sleep behaviors upon enrollment, wore an actigraph and completed a sleep log at home for 7 days, and completed a self-report measure of sleep disruption on day 7 of the study.;Results: 84 autologous HSCT recipients (age M = 60, 45% female) were enrolled and provided complete data. Forty-one percent of patients met criteria for sub-clinical or clinical insomnia based on patient self-report. Examination of actigraph data indicated that certain aspects of sleep were poorer than others (wake after sleep onset M = 66 minutes; total sleep time M = 6.5 hours; sleep efficiency M = 78%; sleep onset latency M = 21 minutes). Measures of cancer-related distress, fear of cancer recurrence, cognitive distortions, and maladaptive behavioral patterns were related to subjectively reported sleep disruption, p's < .05, but were not related to objectively measured sleep disruption. Further examination revealed that the cognitive and behavioral factors accounted for the largest unique variance in subjectively reported sleep disruption.;Conclusion: Results from the present study suggest that many HSCT recipients continue to experience sleep disruption during the survivorship period following transplant. Cancer-specific factors, dysfunctional cognitions about sleep, and maladaptive sleep behaviors were related to self-reported sleep disruption and are ripe targets for a cognitive behavioral intervention.