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14-07-2013 | Oncology | Article

Sleep disturbance persists in women with ovarian cancer


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medwireNews: Sleep disturbance appears to be common in women with ovarian cancer and persists for up to 1 year after diagnosis, study findings show.

Disturbed sleep in these women also impacted on their quality of life (QoL), a finding that according to the researchers highlights the need for “ongoing screening for sleep disturbance in clinical cancer care.”

The team recommends that screening be carried out at the time of diagnosis as well as during treatment and follow up, given that 64.8% of 108 women studied reported disturbed sleep 1 year after being diagnosed, and that sleep disturbance was bad enough for sleep to be rated “clinically impaired” in 19.4%.

A total of 173 women with an average age of 56 years were diagnosed with epithelial ovarian cancer. Prior to surgery, 70.7% of the women reported disturbed global sleep, scoring above 5 on the Pittsburgh Sleep Quality Index (PSQI). Of these women, 24.3% scored at least 10 on the PSQI; a rating that indicated their sleep was clinically impaired.

In the 6 months following surgery, there was a significant improvement in sleep quality, but more than half (58%) of the 119 women available for assessment still reported disturbed sleep, which was in the clinically impaired range for 14.3%. And there was no further improvement in sleep quality between 6 months and 1 year after diagnosis.

Depression was associated with sleep quality, and increased levels from surgery to the 1-year follow up were associated with less improvement in overall sleep quality.

This is in line with previous findings in patients with metastatic breast cancer, researchers Susan Lutgendorf (University of Iowa, Iowa City, USA) and colleagues comment in Cancer. Anxiety levels, however, were unrelated.

The team also notes that, unlike sleep quality, depression improved to nonclinical levels in most of the women over time.

Other factors predicting sustained sleep disturbance included use of pain medication and premenopausal status.

Hypnotic, antidepressant, anxiolytic, and pain medications did not appear to facilitate improved sleep, the researchers report, so “other effective interventions for sleep disturbance may be need to be explored.”

They suggest behavioral interventions such as cognitive behavioral therapy and mindfulness-based stress reduction.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Lucy Piper, Senior medwireNews Reporter

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