UCSF

Problem: Sleep disturbance is a prevalent symptom that affects up to 88% of oncology patients. It is significant problem for oncology patients due to its association with increased fatigue, depression and vasomotor/endocrine symptoms; poorer functional status and quality of life; and potentially disease progression.

Study Objectives: Study purposes were to identify subgroups of patients with distinct sleep disturbance profiles and to evaluate for differences in demographic, clinical, and various sleep characteristics, as well for differences in the severity of co-occurring symptoms among these subgroups.

Methods: Outpatients with breast, gynecological, gastrointestinal, or lung cancer (n=1331) completed questionnaires six times over two chemotherapy (CTX) cycles. Sleep disturbance was evaluated using the General Sleep Disturbance Scale (GSDS). Latent profile analysis was used to identify distinct subgroups.

Results: Three latent classes with distinct sleep disturbance profiles were identified (Low (25.5%), High (50.8%), Very High (24.0%)). Approximately 75% of the patients had a mean total GSDS score that was above the clinically meaningful cutoff score of 43 across all six assessments. Compared to patients in the Low class, patients in High and Very High classes were significantly younger; had a lower functional status; had higher levels of comorbidity; and were more likely to be female, more likely to have childcare responsibilities, less likely to be employed, and less likely to have gastrointestinal cancer. For all of the GSDS subscale and total scores, significant differences among the latent classes followed the expected pattern (Low

Conclusions: Clinicians need to perform in-depth assessments of sleep disturbance and co-occurring symptoms to identify high-risk patients and recommend appropriate interventions.