Insomnia in Patients With Advanced Cancer

Abstract

INTRODUCTION: Insomnia is underrecognized in patients with cancer. By identifying clinical correlations and predisposing factors of insomnia, interventions may be initiated to treat insomnia. METHODS: Consecutive patients referred to palliative medicine services were screened with a single question. Patients answering affirmatively completed the Insomnia Severity Index (ISI). Patients were screened for depression, fatigue, and pain. Spearman correlation was performed for associations. RESULTS: Of 715 consecutive patients, 102 had sleep problems and 64 had clinical insomnia by the ISI criteria. Insomnia correlated with depression (r = .32), pain (r = .29), and tiredness (r = .40) but not with age or precipitating factors. DISCUSSION: Insomnia severity moderately correlates with depression, pain, and tiredness. We found no association of insomnia severity with age or medications. CONCLUSION: Insomnia, pain, depression, and tiredness are a symptom cluster.

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