Abstract
Abstract Introduction More than 50% of cancer survivors suffer from insomnia symptoms before, during or after cancer treatments, which may eventually progress to an insomnia disorder if not addressed. The current study aims to identify which of the demographic and clinical characteristics relate to subthreshold and clinical insomnia categorized according to Insomnia Severity Index (ISI), among heterogeneous sample of cancer survivors with insomnia symptoms (ISI score >7). Methods Baseline data from participants (n=136) from an ongoing trial were used. All participants completed demographic and clinical characteristic assessments (e.g., ISI, Pittsburgh Sleep Quality Index [PSQI], Hospital Anxiety and Depression Scale [HADS], 7-day sleep diary). Descriptive statistics were calculated for demographic and clinical variables. Bivariate comparisons of these variables by insomnia subgroups (subthreshold vs. clinical insomnia) were performed using Fisher's exact test. Results The sample included 60 breast, 48 prostate, 19 colorectal, and 7 lung cancer survivors (55.9% female; age=63.8 y, range: 32-82; 87.5% White; BMI=27.9±6.1 kg/m2). The analytical sample (n=134) comprised of 64.7% (n=88) subthreshold and 33.8% (n=46) clinical insomnia subgroups. Those in subthreshold subgroup consisted of more females (n=54, 40.3% vs. n=20, 14.9%), ≥ 65 y (n=51, 38.1% vs. n=22, 16.4%), and >25 BMI (n=55, 41.0% vs. n=35, 26.1%) than those in clinical subgroup. No statistically significant association between previously discussed variables were found. Both subthreshold and clinical insomnia groups had higher number of those with poor sleep quality than good, and sleep efficiency less than 85% than those with ≥85%, by PSQI and sleep diary, respectively. Of the subthreshold subgroup, 87 (64.9%) were identified as having no symptoms of depression, and 80 (59.7%) as having no anxiety, compared to those with symptoms. This was similar for the clinical subgroup where 37 (27.6%) had no symptoms of depression and 27 (20.1%) with no anxiety, compared to those with symptoms. There were statistically significant associations between insomnia subgroups and depression (p<.001) and anxiety (p<.001), respectively. Conclusion Preliminary descriptive findings highlight significant characteristics of cancer survivors with subthreshold and clinical insomnia. More clinical symptoms were present among clinical insomnia group. PSQI may identify poor sleepers in cancer survivors. Support (if any) NIH/NINR R01NR018215 (Dean), ClinicalTrials-NCT03810365
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