Evaluation of sleep quality and quality of life among patients newly diagnosed with head and neck cancer

Document Type

Conference Proceeding

Publication Date

5-28-2025

Publication Title

J Clin Oncol

Abstract

Background: Patients diagnosed with head and neck cancer (HNC) often suffer from distress attributed to their cancer diagnosis which may disturb their sleep, in turn impacting their quality of life (QoL). However, there is lack of research about the association between poor sleep quality and QoL among patients newly diagnosed with HNC. We assessed the association between in poor sleep quality and QoL among patients with HNC before starting treatment. Methods: This is a retrospective cohort study of patients with HNC between January 2019 and September 2022. All patients with HNC treated at this tertiary care health system are evaluated prior to starting treatment by psych-oncology, using a semi-structured assessment and validated measures including the FACT-HN and Insomnia Severity Index (ISI). The FACTHN is a 27-item validated instrument that consists of five subscales: that assesses the patient's quality of life in the physical, social/family, emotional, functional domains, and HNC-specific domains. Sleep quality was assessed via ISI, a 7-item self-report questionnaire assessing the nature, severity, and impact of sleep difficulties (defined as absence, sub-threshold, moderate, or severe). We used five beta regression models to examine the association between sleep quality via the ISI and QoL via the FACT-HN (one for each subscale: emotional, social, physical, functional, and hand and neck). These models are adjusted with a variety of demographic covariates and social factors along with clinical factors. To estimate confidence intervals, bootstrap methods with bias correction were employed. Results: The analysis included 312 patients, 5.4% reported severe and 15.1% moderate sleep difficulties. After adjusting for other covariates, sleep difficulties were significantly associated with all FACT-HN subscales. Compared to patients with no sleep difficulties, patients with severe difficulties had a decrease in emotional (β=-1.33, 95% CI, -1.67, -0.93), social (β=-0.90, 95% CI, -1.66, -0.37), physical (β=-2.27, 95% CI, -2.67, -1.74), functional (β=-1.64, 95% CI, -2.10, -0.87), and head and neck (β=-1.11, 95% CI, -1.58, -0.65) QoL. Similarly, compared to patients with no sleep difficulties, those with severe difficulties had a decrease in emotional (β=-1.34,95%CI, -1.66, -0.98), social (β=-0.61, 95% CI, -0.99, -0.17), physical (β=-1.85, 95% CI, -2.18, -1.49), functional (β=-1.37, 95% CI, -1.71, -0.89), and head and neck (β=-1.04, 95% CI, -1.34, -0.69) QoL. Conclusions: We found that patients with moderate or severe sleep difficulties had poor QoL. Early evaluation and tailored intervention to improve sleep quality are necessary to prepare these patients for HNCtreatment and its consequences. Future studies are needed on sleep quality among patients during and after treatment.

Volume

43

Issue

16 Suppl

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