1019 Subjective Sleep Quality and Sleep Recommendations Received by Patients with Cancer and Depression

Abstract

Abstract Introduction Diagnoses of cancer and depression are independent predictors of poor sleep, but less is known about subjective sleep quality among patients with both of these potential risk factors or about recommendations made by physicians for improving sleep among this population. This study examines correlates of poor subjective sleep quality and sleep recommendations received by patients with cancer enrolled in the Collaborative Oncology Project to Enhance Depression Care (COPE-D), a collaborative care intervention to treat depression among patients with cancer. Methods Participants were 74 adult cancer survivors. Demographic and clinical characteristics, subjective sleep quality, and provider sleep recommendations were obtained by patient self-report prior to intervention. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), general health status was measured using the PROMIS Global-10, and depressive symptoms were measured using the PHQ-9. Results 81% of patients reported significantly poor sleep quality (PSQI global scores >8) and 75.3% reported poor sleep efficiency (<85%). The strongest correlates of poor sleep quality were worse global mental (r=-.431, p<.01) and physical health (r=-.40, p=<.01). 63% reported pain interference with sleep at least once per week. Cancer type and stage, current cancer treatment, and depressive symptoms were not significantly associated with poor sleep quality (p’s>.05). 12% of those reporting sleep disturbances since their cancer diagnosis had not discussed these problems with a medical provider. Among those who talked to their provider, 41.8% reported receiving sleep hygiene recommendations, 40.5% anti-depressants, 14.9% sedative-hypnotic medication (e.g. zolpidem, benzodiazepines), 10.8% cognitive behavioral therapy, 9.6% antihistamines, 6.8% melatonin, and 4.1% were recommended meditation or hypnosis. Conclusion Cancer patients seeking treatment for depression report very high rates of poor subjective sleep quality, which was most strongly associated with global mental and physical health. Improved screening and patient-provider communication about sleep may be especially beneficial for this at-risk population. Support Merck Foundation Alliance to Advance Patient-Centered Cancer Care