Article of the Month

DIFFERENCES IN SLEEP DISTURBANCE PARAMETERS BETWEEN ONCOLOGY OUTPATIENTS AND THEIR FAMILY CAREGIVERS

Carney S, Koetters T, Cho M, West C, Paul SM, Dunn L, Aouizerat BE, Dodd M, Cooper B, Lee K, Wara W, Swift P, Miaskowski C. J Clin Oncol. 2011; 29/8: 1001-1006.

The prevalence of sleep disturbances in cancer patients is about 30%-55% which is double the general population. There is neither data about the sleep problems of the patients who live with their spouses nor of the family caregivers (FCs) living with the patients.

In a descriptive study, the authors compared the occurrence rate for, and severity ratings of, sleep disturbance in patient-family caregiver (FC) dyads.  102 dyads were enrolled in 2 departments of radiation therapy (RT) during a simulation visit for primary or adjuvant RT for breast, lung, or brain cancers. The patients had no metastases and had a Karnosky Performance Status ≥ 60.

Both the patients and FCs completed the Pittsburgh Sleep Quality Index (PSQI - quality of sleep in the last month); the General Sleep Disturbance Scale (GSDS quality of sleep in the last week) and they wore a wrist actigraph (to measure activity) in order to obtain subjective and objective measures of the occurrence and severity of sleep disturbance at the initiation of RT.

The patients were significantly older than FCs and more frequently the gender was male.
The occurrence of significant clinical levels of sleep disturbance ranged from 40% to 50% using subjective and objective measures with no differences between patients and their FCs.

The patients more frequently used hypnotic-sedative drugs and had a higher severity of the sleep-wake parameters.

The correlations between the patients and their FCs regarding the quality, latency, duration, efficacy of the sleep scores and the consequent discomfort during the day showed no difference.

Why I chose this article
Sleep problems are frequently assessed in patients with cancer but no data were available on the sleep disturbance of family caregivers.

The findings from this study suggest that both cancer patients and their family caregivers suffer similar levels of sleep disturbance. This is an indication that we should not only take into consideration specific problems of patients but also the affects of the patient’s illness and treatment on the wellbeing of family caregivers also.