Insomnia in cancer populations: preliminary exploration of the relationship between insomnia and cancer-related quality of life

L. Fleming, L. Taylor, J. Paul, C White, J. Cassidy, N. Douglas, L. Samuel, C. A. Espie

Research output: Contribution to journalConference Contribution


Insomnia is common in cancer patients. Kaye et al. found that 45% of cancer patients had insomnia compared with 14% of controls. In 1998, Tjemsland et al. reported one-third of breast cancer patients continuing to have difficulty falling asleep 1 year after surgery, compared to half at 6 week, and in 2001, Savard et al. reported that 43% of women with breast cancer had insomnia symptoms and 21% met diagnostic criteria for chronic insomnia. In 1986, the World Health Organisation stated sleep improvement as one of its primary aims in cancer relief efforts. This priority was later reflected by the finding that sleep problems were ranked the fifth highest of 14 distressing symptoms before cancer treatment and the fourth highest after treatment. Aim : To explore the relationship between cancer-related quality of life and insomnia across a range of cancer types. Methods : This report summarises data drawn from an ongoing RCT of psychological treatment for insomnia in cancer patients. Participants from 4 cancer groups (breast, prostate, colorectal and gynaecological) who satisfied diagnostic criteria for persistent insomnia completed base- line sleep assessments along with a range of rating measures indexing disease specific quality of life. These data were first analysed descriptively, and then correlational methods were applied to investigate the association between sleep and QoL. Results : Of the first 133 participants (44M/89F, mean age Z 61yrs) randomised into the trial, 78 (58.6%) had breast cancer, 31 (23.3%) had prostate cancer, 22 (16.5%) had colorectal cancer and 2 (1.6%) had gynaecological cancer. Preliminary descriptive analyses of baseline sleep variables (i.e. Pittsburgh Sleep Quality Index (PSQI), Dysfunctional Beliefs and Attitudes Scale (DBAS-10) and Sleep Diary) were calculated. The Sleep Diary data show mean (SD) scores of 47.56 mins (39.73) (SOL), 82.58 mins (64.34) (WASO), 384.14 mins (105.87) (TST) and 74.43% (18.32) (SE). The rating scale data indicate mean (SD) scores of 13.31 (2.87) (PSQI) and 5.20 (1.66) (DBAS-10). Correlational analyses were conducted on these clinically relevant sleep variables and on cancer-related QoL measures. These analyses indicated several significant relationships involving small to moderate correlation between (i) physical QoL (PQoL) and PSQI scores (r Z 0.22, p Z 0.04), (ii) PQoL and DBAS-10 scores (r Z 0.30, p Z 0.004), (iii) emotional QoL (EQoL) and DBAS-10 scores (r Z 0.22, p Z 0.035), (iv) functional QoL (FQoL) and PSQI scores (r Z 0.34, p Z 0.001) and (v) FQoL and DBAS-10 scores (r Z 0.26, p Z 0.015). Conclusions : These data indicate the existence of a significant relationship between physical, emotional and functional cancer-related quality of life variables and clinically relevant sleep variables. Research supported by Cancer Research UK (C8265/A3036)
Original languageEnglish
Article numberP 005
Pages (from-to)S120-S121
Number of pages1
JournalSleep Medicine
Issue numberSuppl. 2
Publication statusPublished - 31 Oct 2005
Externally publishedYes
EventWorld Association of Sleep Medicine (WASM): First Congress, Advancing Sleep Health Worldwide - Berlin, Germany
Duration: 15 Oct 200518 Oct 2005


  • insomnia
  • cancer
  • quality of life


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