Patient Reported Outcomes/Quality of Life

PV QA 4 - Poster Viewing Q&A 4

TU_44_3752 - Long-Term Trends in Sleep Disturbance and Prescription Sleep Aid Use among Cancer Survivors in the United States

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Long-Term Trends in Sleep Disturbance and Prescription Sleep Aid Use among Cancer Survivors in the United States
A. N. Slade1, M. R. Waters2, and N. Serrano3; 1VCU Massey Cancer Center, Richmond, VA, 2Virginia Commonwealth University Health System, Richmond, VA, 3Virginia Commonwealth University, Richmond, VA

Purpose/Objective(s): Insomnia is a common complaint among cancer patients and can be up to three times as prevalent compared to the general population. The use of prescription sleep aids, however, is less clear. Moreover, as most previous literature has focused on patients with breast cancer, little is known about the prevalence of sleep aid use in survivors of other cancer sites. This study analyzes a nationally representative survey to determine the extent to which a cancer diagnosis contributes to sleep disturbances and prescription sleep aid use.

Materials/Methods: We used data from five cross-sectional waves of the National Health and Nutrition Evaluation Survey from 2005-2014. We identified a total of 2,371 individuals who reported a diagnosis of cancer and 25,788 individuals who did not report a cancer diagnosis. The self-reported outcomes we use include whether a patient reports trouble sleeping to a doctor, as well as if a patient reports being told by a doctor they have a sleep disorder. Additionally, we utilize the patient’s reported drug list to consider whether they are taking a prescription drug classified as a “miscellaneous anxiolytic, sedative or hypnotic”, which include many common prescription sleep agents. Bivariate and multivariate regression analyses were used to clarify the relationship between sleep disturbances, prescription sleep aid use, and cancer diagnosis and site of disease. Multivariate analyses controlled for multiple demographic, socioeconomic, and medical factors.

Results: Reported sleep disturbance was common in cancer survivors, with approximately 34% of patients with a history of cancer reporting trouble sleeping to a doctor, compared to 23% of non-cancer patients (p<0.001). These trends were similar in being diagnosed with a sleep disorder or using a prescription sleep aid (12% vs. 9% and 3.3% vs 2.2%, respectively; p<0.001). The use of prescription sleep aids did not abate as individuals progressed through cancer survivorship; nearly 38% of patients who were more than 11 years past their original cancer diagnosis reported sleep aid use. Prescription sleep aid use was highest in patients reporting CNS cancers (18%), lung cancer (10.8%) and gynecological cancers (6.2%). Patients with head and neck cancers reported a high rate of trouble sleeping (44%) but a very low rate of prescription drug use (1.4%). On multivariate analysis, a cancer diagnosis raised the risk of reporting trouble sleeping (OR 1.20, p<0.01), with CNS, lung and gynecological cancer survivors driving this relationship (OR 5.1, 1.3, and 1.5, respectively; p<0.05). Prescription sleep aid use was increased in the lung and gynecological patient cohort (OR 3.6 and 2.2, respectively).

Conclusion: Insomnia and prescription sleep aid use is common in the cancer survivorship population, especially in patients with a history of lung, central nervous system, and gynecological cancers. Consideration of symptoms of insomnia and sleep disturbance may be helpful in the follow-up care of these patients.

Author Disclosure: A.N. Slade: None. M.R. Waters: None.

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