Sleep Quality of Patients with Differentiated Thyroid Cancer

Yajing He, Zhaowei Meng, Qiang Jia, Fang Hu, Xianghui He, Jian Tan, Guizhi Zhang, Xue Li, Jianping Zhang, Qing Zhang, Li Liu, Lili Zhao, Jing Li, Yuling Wang, Yumei Qian, Shuling Hou, Hua Liu, Sheng Wang, Renfei Wang, Wei Zheng, Tianpeng Hu, Na Liu, Arun Upadhyaya, Yang Liu, Yajing He, Zhaowei Meng, Qiang Jia, Fang Hu, Xianghui He, Jian Tan, Guizhi Zhang, Xue Li, Jianping Zhang, Qing Zhang, Li Liu, Lili Zhao, Jing Li, Yuling Wang, Yumei Qian, Shuling Hou, Hua Liu, Sheng Wang, Renfei Wang, Wei Zheng, Tianpeng Hu, Na Liu, Arun Upadhyaya, Yang Liu

Abstract

Objective: We aimed to measure prevalence of sleep disturbance in patients with differentiated thyroid cancer (DTC) by calculating Pittsburgh Sleep Quality Index (PSQI), and compare these data with patients with benign thyroid nodules or normal participants.

Methods: Three groups of patients participated in this cross-sectional study. In the first group, 162 patients with DTC received total thyroidectomy, and then 131I therapy. The second group consisted of 84 patients with benign thyroid nodules, who received partial thyroidectomy. The third group was 78 normal healthy control cases. PSQI was used to assess the sleep quality. Inter-group differences were analyzed by Kruskal-Wallis test or independent samples T test. χ2 test was also used to check prevalence differences of poor sleep quality among the groups. Differences of PSQI score and poor sleep quality prevalence before and after 131I therapy in the same group of DTC participants were analyzed by paired T test and Mcnemar's test.

Results: Higher PSQI score (7.59 ± 4.21) and higher rate of poor sleep quality (54.32%) were shown in DTC patients than in any other group. After 131I therapy, PSQI score and prevalence of poor sleep quality in DTC patients increased significantly to 8.78 ± 4.72 and 70.99%. Then DTC patients were divided into two subgroups based on their metastatic status. DTC patients with metastasis (87/162 cases, 53.70%) had significantly higher PSQI score (10.87 ± 5.18) and higher prevalence of poor sleep quality (79.31%).

Conclusion: DTC patients suffer from sleep disturbance, 131I therapy and awareness of metastatic status could worsen sleep problem. Psychological fear of cancer, nuclear medicine therapy and metastasis could be one major underlying reason. Longitude and interventional studies are necessary for further investigations.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Mercadante S, Girelli D, Casuccio A. Sleep disorders in advanced cancer patients: prevalence and factors associated. Support Care Cancer. 2004;12(5):355–9. Epub 2004/04/06. 10.1007/s00520-004-0623-4 .
    1. Mullington JM, Haack M, Toth M, Serrador JM, Meier-Ewert HK. Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation. Prog Cardiovasc Dis. 2009;51(4):294–302. Epub 2008/12/27. S0033-0620(08)00091-1 [pii] 10.1016/j.pcad.2008.10.003
    1. Berger AM. Update on the state of the science: sleep-wake disturbances in adult patients with cancer. Oncol Nurs Forum. 2009;36(4):E165–77. Epub 2009/07/08. U1N93PP011Q61882 [pii]. 10.1188/09.ONF.E165-E177 .
    1. Dahiya S, Ahluwalia MS, Walia HK. Sleep disturbances in cancer patients: underrecognized and undertreated. Cleve Clin J Med. 2013;80(11):722–32. Epub 2013/11/05. 80/11/722 [pii]. 10.3949/ccjm.80a.12170 .
    1. Phillips KM, Jim HS, Donovan KA, Pinder-Schenck MC, Jacobsen PB. Characteristics and correlates of sleep disturbances in cancer patients. Support Care Cancer. 2012;20(2):357–65. Epub 2011/02/12. 10.1007/s00520-011-1106-z .
    1. Becze E. Identify and treat sleep-wake disturbances in patients with cancer. ONS Connect. 2009;24(10):22–3. Epub 2009/10/29. .
    1. Liu L, Ancoli-Israel S. Sleep Disturbances in Cancer. Psychiatr Ann. 2008;38(9):627–34. Epub 2008/09/01.
    1. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64(1):9–29. Epub 2014/01/09. 10.3322/caac.21208 .
    1. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214. Epub 2009/10/29. 10.1089/thy.2009.0110 .
    1. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213. Epub 1989/05/01. 0165-1781(89)90047-4 [pii]. 2748771.
    1. Colagiuri B, Christensen S, Jensen AB, Price MA, Butow PN, Zachariae R. Prevalence and predictors of sleep difficulty in a national cohort of women with primary breast cancer three to four months postsurgery. J Pain Symptom Manage. 2011;42(5):710–20. Epub 2011/05/31. S0885-3924(11)00155-2 [pii]. 10.1016/j.jpainsymman.2011.02.012 .
    1. Tian J, Chen GL, Zhang HR. Sleep status of cervical cancer patients and predictors of poor sleep quality during adjuvant therapy. Support Care Cancer. 2014. Epub 2014/11/06. 10.1007/s00520-014-2493-8 .
    1. Gooneratne NS, Dean GE, Rogers AE, Nkwuo JE, Coyne JC, Kaiser LR. Sleep and quality of life in long-term lung cancer survivors. Lung Cancer. 2007;58(3):403–10. Epub 2007/09/04. S0169-5002(07)00418-7 [pii]. 10.1016/j.lungcan.2007.07.011
    1. Savard J, Simard S, Blanchet J, Ivers H, Morin CM. Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep. 2001;24(5):583–90. Epub 2001/08/02. .
    1. Savard J, Morin CM. Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol. 2001;19(3):895–908. Epub 2001/02/07. .
    1. Roscoe JA, Kaufman ME, Matteson-Rusby SE, Palesh OG, Ryan JL, Kohli S, et al. Cancer-related fatigue and sleep disorders. Oncologist. 2007;12 Suppl 1:35–42. Epub 2007/08/01. 12/suppl_1/35 [pii]. 10.1634/theoncologist.12-S1-35 .
    1. Berger AM, Sankaranarayanan J, Watanabe-Galloway S. Current methodological approaches to the study of sleep disturbances and quality of life in adults with cancer: a systematic review. Psychooncology. 2007;16(5):401–20. Epub 2006/08/25. 10.1002/pon.1079 .
    1. Garrett K, Dhruva A, Koetters T, West C, Paul SM, Dunn LB, et al. Differences in sleep disturbance and fatigue between patients with breast and prostate cancer at the initiation of radiation therapy. J Pain Symptom Manage. 2011;42(2):239–50. Epub 2011/04/02. S0885-3924(11)00053-4 [pii]. 10.1016/j.jpainsymman.2010.11.010
    1. Thomas KS, Bower J, Hoyt MA, Sepah S. Disrupted sleep in breast and prostate cancer patients undergoing radiation therapy: the role of coping processes. Psychooncology. 2010;19(7):767–76. Epub 2009/11/04. 10.1002/pon.1639
    1. Savard J, Simard S, Hervouet S, Ivers H, Lacombe L, Fradet Y. Insomnia in men treated with radical prostatectomy for prostate cancer. Psychooncology. 2005;14(2):147–56. Epub 2004/09/24. 10.1002/pon.830 .
    1. Savard J, Liu L, Natarajan L, Rissling MB, Neikrug AB, He F, et al. Breast cancer patients have progressively impaired sleep-wake activity rhythms during chemotherapy. Sleep. 2009;32(9):1155–60. Epub 2009/09/16.
    1. Meng Z, Lou S, Tan J, Xu K, Jia Q, Zheng W. Nuclear factor-kappa B inhibition can enhance apoptosis of differentiated thyroid cancer cells induced by 131I. PLoS One. 2012;7(3):e33597 Epub 2012/03/23. 10.1371/journal.pone.0033597 PONE-D-11-19660 [pii].
    1. Kouvaraki MA, Shapiro SE, Fornage BD, Edeiken-Monro BS, Sherman SI, Vassilopoulou-Sellin R, et al. Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery. 2003;134(6):946–54; discussion 54–5. Epub 2003/12/12. 10.1016/S0039 S0039606003004240 [pii]. .
    1. Souza Rosario PW, Barroso AL, Rezende LL, Padrao EL, Fagundes TA, Penna GC, et al. Post I-131 therapy scanning in patients with thyroid carcinoma metastases: an unnecessary cost or a relevant contribution? Clin Nucl Med. 2004;29(12):795–8. Epub 2004/11/17. 00003072-200412000-00005 [pii]. .
    1. Wong KK, Zarzhevsky N, Cahill JM, Frey KA, Avram AM. Incremental value of diagnostic 131I SPECT/CT fusion imaging in the evaluation of differentiated thyroid carcinoma. AJR Am J Roentgenol. 2008;191(6):1785–94. Epub 2008/11/21. 191/6/1785 [pii]. 10.2214/AJR.08.1218 .
    1. Chen WY, Giobbie-Hurder A, Gantman K, Savoie J, Scheib R, Parker LM, et al. A randomized, placebo-controlled trial of melatonin on breast cancer survivors: impact on sleep, mood, and hot flashes. Breast Cancer Res Treat. 2014;145(2):381–8. Epub 2014/04/11. 10.1007/s10549-014-2944-4
    1. Joffe H, Partridge A, Giobbie-Hurder A, Li X, Habin K, Goss P, et al. Augmentation of venlafaxine and selective serotonin reuptake inhibitors with zolpidem improves sleep and quality of life in breast cancer patients with hot flashes: a randomized, double-blind, placebo-controlled trial. Menopause. 2010;17(5):908–16. Epub 2010/06/29. 10.1097/gme.0b013e3181dbee1b .
    1. Berger AM, Kuhn BR, Farr LA, Von Essen SG, Chamberlain J, Lynch JC, et al. One-year outcomes of a behavioral therapy intervention trial on sleep quality and cancer-related fatigue. J Clin Oncol. 2009;27(35):6033–40. Epub 2009/11/04. JCO.2008.20.8306 [pii]. 10.1200/JCO.2008.20.8306
    1. Berger AM, Kuhn BR, Farr LA, Lynch JC, Agrawal S, Chamberlain J, et al. Behavioral therapy intervention trial to improve sleep quality and cancer-related fatigue. Psychooncology. 2009;18(6):634–46. Epub 2008/12/19. 10.1002/pon.1438 .
    1. Courneya KS, Segal RJ, Mackey JR, Gelmon K, Friedenreich CM, Yasui Y, et al. Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial. Breast Cancer Res Treat. 2014;144(2):361–9. Epub 2014/02/21. 10.1007/s10549-014-2883-0 .
    1. Mustian KM, Sprod LK, Janelsins M, Peppone LJ, Palesh OG, Chandwani K, et al. Multicenter, randomized controlled trial of yoga for sleep quality among cancer survivors. J Clin Oncol. 2013;31(26):3233–41. Epub 2013/08/14. JCO.2012.43.7707 [pii]. 10.1200/JCO.2012.43.7707

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться