Prostate cancer treatments and their side effects are associated with increased insomnia
Version of Record online: 8 AUG 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Volume 22, Issue 6, pages 1381–1388, June 2013
How to Cite
Savard, J., Hervouet, S. and Ivers, H. (2013), Prostate cancer treatments and their side effects are associated with increased insomnia. Psycho-Oncology, 22: 1381–1388. doi: 10.1002/pon.3150
- Issue online: 6 JUN 2013
- Version of Record online: 8 AUG 2012
- Manuscript Accepted: 12 JUL 2012
- Manuscript Revised: 6 JUL 2012
- Manuscript Received: 20 MAR 2012
- prostate cancer;
- androgen deprivation therapy;
- radiation therapy;
- side effects
Between 25% and 40% of prostate cancer patients report insomnia symptoms. Although a possible role of androgen deprivation therapy (ADT) and radiation therapy (RTH) and some of their side effects have been postulated, this issue has rarely been investigated. This study aimed to (1) compare the evolution of insomnia symptoms and somatic symptoms, which may affect sleep quality (i.e., hot flashes, night sweats, and urinary symptoms), in patients receiving combined ADT and RTH with that in patients receiving RTH only and (2) assess the mediating role of somatic symptoms in the relationship of ADT and RTH with insomnia symptoms.
Sixty men scheduled to receive RTH for prostate cancer, with (n = 28) or without (n = 32) ADT, were assessed prior to receiving any treatment (baseline) and at seven additional times over 16 months (1, 2, 4, 6, 8, 12, and 16 months) using the Insomnia Severity Index and the Physical Symptoms Questionnaire.
A significant interaction effect was found indicating an increase in insomnia scores in ADT–RTH patients at 2, 4, and 6 months, as compared with baseline, and stable scores in RTH patients. A significant mediating role of hot flashes and night sweats was found in the relationship between ADT and insomnia symptoms. The relationship with RTH was also significantly mediated by these two symptoms albeit more strongly by excessive urinary frequency.
Androgen deprivation therapy is associated with an increased risk for insomnia, and side effects of ADT and RTH appear to play a role in the development of insomnia in this population. Copyright © 2012 John Wiley & Sons, Ltd.