Cancer related insomnia and wireless technology: A pilot study.

Abstract

e21645 Background: Cancer related insomnia (CRI) includes difficulty with sleep onset, maintenance or non-restorative sleep. CRI is common with prevalence up to 95%. Consequences include cognitive dysfunction, fatigue, increased hospitalisation and lost work productivity. Early detection may help. CRI remains under-investigated as objective assessment has needed specialised laboratories. Mobile technology may provide a solution. This study aimed to determine the feasibility and acceptability of a wireless bedside monitor (SleepMinder [ResMed Sensor Technologies Ltd, Dublin]) to evaluate CRI. Methods: A prospective observational study recruited 10 consecutive hospice inpatients (IP) and 20 consecutive community participants (CP) with cancer. Participants used a wireless non-contact bedside sleep monitor for 3 consecutive nights. Three insomnia features were examined (sleep onset, maintenance, early awakening). Computerised algorithm-generated metrics were compared to visual inspection of the monitor sleep/activity report. Acceptability questionnaires were completed by patient, nurse and family. Results: The device successfully recorded sleep patterns in all 30 participants. No technical difficulties were experienced. IP: Mean age was 63 +/- 9 years. 7/10 had one or more insomnia features with delayed sleep onset most common. The monitor over-estimated Sleep Latency (77% nights), Duration (77% nights) and Final Awakening (63% nights). CP: Mean age was 64 +/- 10 years. 15/20 had one or more insomnia features with poor sleep maintenance most common. The monitor overestimated Sleep Duration (62% nights) and Final Awakening (45% nights). Lower levels were noted in CP as they spent less time in bed. Patients, nurses and family members reported high (100%) device acceptability. Conclusions: A wireless bedside monitor effectively measured sleep in seriously ill cancer patients in both inpatient and outpatient settings without the use of a sleep laboratory High reliability and acceptability supports routine clinical use Sensitivity of wakefulness detection was reduced as the device incorrectly identified sleep during awake but motionless periods Concurrent use of sleep diary and a monitor is recommended for comprehensive assessment