Abstract
PurposeAlthough corticosteroids are frequently used in patients with advanced cancer, few studies have examined the impact of these drugs on patient-reported sleep. We aimed to examine the short-term impact of methylprednisolone on patient-reported sleep in patients with advanced cancer.MethodsPatient-reported sleep was a predefined secondary outcome in a prospective, randomized, placebo-controlled, double-blind trial that evaluated the analgesic efficacy of corticosteroids in advanced cancer patients (18+), using opioids, and having pain ≥ 4 past 24 h (NRS 0–10). Patients were randomized to the methylprednisolone group with methylprednisolone 16 mg × 2/day or placebo for 7 days. The EORTC QLQ-C30 (0–100) and the Pittsburgh Sleep Quality Index questionnaire (PSQI) (0–21) were used to assess the impact of corticosteroids on sleep at baseline and at day 7.ResultsFifty patients were randomized of which 25 were analyzed in the intervention group and 22 in the control group. Mean age was 64 years, mean Karnofsky performance status was 67 (SD 13.3), 51% were female, and the mean oral daily morphine equivalent dose was 223 mg (SD 222.77). Mean QLQ-C30 sleep score at baseline was 29.0 (SD 36.7) in the methylprednisolone group and 24.2 (SD 27.6) in the placebo group. At day 7, there was no difference between the groups on QLQ-C30 sleep score (methylprednisolone 20.3 (SD 32.9); placebo 28.8 (SD 33.0), p = 0.173). PSQI showed similar results.ConclusionsMethylprednisolone 16 mg twice daily for 7 days had no impact on patient-reported sleep in this cohort of patients with advanced cancer.Trial registrationClinical trial information NCT00676936 (13.05.2008)
Highlights
Patients with advanced cancer often report poor sleep quality with a prevalence that varies from 40 to 96% across studies [1,2,3,4,5,6]
Corticosteroids are associated with a variety of adverse effects in which sleep disturbance is one of the short-term effects [12,13,14,15]
These drugs are frequently administered to patients with advanced cancer [16,17,18,19,20,21], but usage varies between countries
Summary
Patients with advanced cancer often report poor sleep quality with a prevalence that varies from 40 to 96% across studies [1,2,3,4,5,6]. Treatment with corticosteroids may be a precipitating factor involved in the development of insomnia in patients with cancer [8,9,10,11]. Corticosteroids are associated with a variety of adverse effects in which sleep disturbance is one of the short-term effects [12,13,14,15]. These drugs are frequently administered to patients with advanced cancer [16,17,18,19,20,21], but usage varies between countries. Some patients use corticosteroids as a part of anti-cancer therapy or for other medical conditions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
