Insomnia in patients undergoing Autologous Hematopoietic Stem Cell Transplantation

Abstract

Background: Insomnia has an elevated incidence in patients who receive autologous Hematopoietic Stem Cell Transplantation (HSCT), which can lead to psychic and physical dysfunctions and impair immunological and neuroendocrine processes, hence compromising the response to treatment. The aim of this study is to evaluate the incidence, severity, and changes in time of insomnia in patients following autologous HSCT. Identify the factors affecting the quality of sleep and, in the end, identify the number of nocturnal awakenings and night interruptions by healthcare personnel.Methods: insomnia was detected through the Insomnia Severity Index (ISI) questionnaire. The questionnaire was handed out in three different periods: on the first day of hospitalization (T0), the day after the transplantation (T1), and at the discharge (T2). The questionnaire was given out at the hematology ward in two hospitals in Italy.Results: The convenience sample consisted of 31 patients. 42% of patients (N=13) in the pre-hospitalization, 58% (N=18) the day of transplantation, and 65% (N=20) at discharge showed insomnia symptoms: a significant difference between the ISI score at T0 and the ISI score at T1 and T2. There was a relationship between the ISI score and the presence of adverse effects of chemotherapy.Conclusion: Insomnia is already present in patients following autologous HSCT from pre-admission and worsens during hospitalization. In detecting the symptoms of insomnia, the nurse plays an important role. Multidisciplinary management, both medical and nursing, is essential.