Sleep disturbance, distress, and quality of life in ovarian cancer patients during the first year after diagnosis

Authors

  • Lauren Clevenger BA,

    1. Department of Psychology, University of Iowa, Iowa City, Iowa
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  • Andrew Schrepf BA,

    1. Department of Psychology, University of Iowa, Iowa City, Iowa
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  • Koenraad DeGeest MD,

    1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
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  • David Bender MD,

    1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
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  • Michael Goodheart MD,

    1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
    2. Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
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  • Amina Ahmed MD,

    1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
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  • Laila Dahmoush MD,

    1. Department of Pathology, University of Iowa, Iowa City, Iowa
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  • Frank Penedo PhD,

    1. Department of Medical Social Sciences, Robert Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
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  • Joseph Lucci III MD,

    1. Division of Gynecologic Oncology and Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
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  • Premal H. Thaker MD,

    1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
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  • Luis Mendez MD,

    1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Florida International University College of Medicine, Miami Beach, Florida
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  • Anil K. Sood MD,

    1. Departments of Gynecologic Oncology and Cancer Biology, and Center for RNA Interference and Non-Coding RNA, University of Texas MD Anderson Cancer Center, Houston, Texas
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  • George M. Slavich PhD,

    1. Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
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  • Susan K. Lutgendorf PhD

    Corresponding author
    1. Department of Psychology, University of Iowa, Iowa City, Iowa
    2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
    3. Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
    4. Department of Urology, University of Iowa, Iowa City, Iowa
    • Corresponding author: Susan K. Lutgendorf, PhD, University of Iowa, E11 Seashore Hall, Iowa City, IA 52242; Fax: (319) 335-0191; Susan-lutgendorf@uiowa.edu

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Abstract

BACKGROUND

Sleep disturbance is a common clinical complaint of oncology patients and contributes to substantial morbidity. However, because most sleep studies have been cross-sectional, associations between sleep quality and distress in patients with ovarian cancer over time remain unclear. This prospective longitudinal study examined rates of sleep disturbance; contributions of depression, anxiety, and medication use in sleep disturbance; and associations between sleep quality and quality of life (QOL) during the first year after diagnosis among women with ovarian cancer.

METHODS

Women with a pelvic mass completed measures of sleep quality, depression, anxiety, and QOL before surgery. Those diagnosed with primary epithelial ovarian, fallopian tube, or peritoneal cancer repeated surveys at 6 months and 1 year after diagnosis. Mixed modeling was used to examine trajectories of psychosocial measures over time, as well as associations between changes in distress and sleep quality. Relationships between changes in sleep and QOL were also examined.

RESULTS

The majority of patients reported disturbed global sleep (Pittsburgh Sleep Quality Index > 5) at all 3 time points. Medications for sleep and pain were associated with worse sleep at all time points. Greater increases in depression were associated with increased disturbances in sleep quality over time (P < .04). Worsening sleep was also associated with declines in QOL over time (P < .001).

CONCLUSIONS

Sleep disturbance is common and persistent in women with ovarian cancer, and is linked to depressive symptoms and QOL. Pharmacologic treatment does not appear to adequately address this problem. Results highlight the need for ongoing screening and intervention for sleep disturbance in this population. Cancer 2013;119:3234–3241. © 2013 American Cancer Society.

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