Predictors of poor sleep quality among head and neck cancer patients

Authors

  • Andrew G. Shuman MD,

    1. Department of Otolaryngology, Michigan, U.S.A.
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  • Sonia A. Duffy PhD, RN,

    1. Department of Otolaryngology, Michigan, U.S.A.
    2. Department of Psychiatry (s.a.d.), and the School of Nursing, University of Michigan, Ann Arbor, Michigan, U.S.A.
    3. Veterans Affairs Center for Clinical Management Research, Health Services Research and Development, Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, U.S.A.
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  • David L. Ronis PhD,

    1. Department of Psychiatry (s.a.d.), and the School of Nursing, University of Michigan, Ann Arbor, Michigan, U.S.A.
    2. Veterans Affairs Center for Clinical Management Research, Health Services Research and Development, Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, U.S.A.
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  • Susan L. Garetz MD,

    1. Department of Otolaryngology, Michigan, U.S.A.
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  • Scott A. McLean MD, PhD,

    1. Department of Otolaryngology, Michigan, U.S.A.
    2. Department of Otolaryngology, Henry Ford Health System, Detroit, Michigan, U.S.A.
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  • Karen E. Fowler MPH,

    1. Veterans Affairs Center for Clinical Management Research, Health Services Research and Development, Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, U.S.A.
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  • Jeffrey E. Terrell MD

    Corresponding author
    1. Department of Otolaryngology, Michigan, U.S.A.
    • Department of Otolaryngology, 1904 Taubman Center, University of Michigan Hospitals, Ann Arbor, MI 48109
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  • Presented at the Triological Society Combined Sections Meeting, Orlando, Florida, U.S.A., February 4–7, 2010. Winner of the 2010 Triological Society Paul Holinger Resident Research Award.

  • This work was supported by the National Institutes of Health through the University of Michigan's Head and Neck Specialized Program of Research Excellence grant (P50 CA97248). The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

The objective of this study was to determine the predictors of sleep quality among head and neck cancer patients 1 year after diagnosis.

Study Design:

This was a prospective, multisite cohort study of head and neck cancer patients (N = 457).

Methods:

Patients were surveyed at baseline and 1 year after diagnosis. Chart audits were also conducted. The dependent variable was a self-assessed sleep score 1 year after diagnosis. The independent variables were a 1 year pain score, xerostomia, treatment received (radiation, chemotherapy, and/or surgery), presence of a feeding tube and/or tracheotomy, tumor site and stage, comorbidities, depression, smoking, problem drinking, age, and sex.

Results:

Both baseline (67.1) and 1-year postdiagnosis (69.3) sleep scores were slightly lower than population means (72). Multivariate analyses showed that pain, xerostomia, depression, presence of a tracheotomy tube, comorbidities, and younger age were statistically significant predictors of poor sleep 1 year after diagnosis of head and neck cancer (P < .05). Smoking, problem drinking, and female sex were marginally significant (P < .09). Type of treatment (surgery, radiation and/or chemotherapy), primary tumor site, and cancer stage were not significantly associated with 1-year sleep scores.

Conclusions:

Many factors adversely affecting sleep in head and neck cancer patients are potentially modifiable and appear to contribute to decreased quality of life. Strategies to reduce pain, xerostomia, depression, smoking, and problem drinking may be warranted, not only for their own inherent value, but also for improvement of sleep and the enhancement of quality of life. Laryngoscope, 2010

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