Insomnia in Patients With Advanced Cancer

1. Mellar P. Davis, MD1⇑Dilara Khoshknabi, MD2,3Declan Walsh, MD3Ruth Lagman, MD3
2. Alexandra Platt, BS3

1. ¹Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Center, Cleveland, OH, USA
2. ²Cleveland Clinic Digestive Disease Institute, Cleveland, OH, USA
3. ³Cleveland Clinic The Harry R Horvitz Center for Palliative Medicine and Supportive Oncology, Cleveland, OH, USA

1. Mellar P. Davis, MD, R-35, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Email: davism6@ccf.org

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.