Neurology

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Sleep-Wake Disturbances in Patients with Advanced Cancer and Their Family Carers
Journal of Pain and Symptom Management, 10/06/09

Gibbins J et al. – Poor sleep was a frequent complaint: 47% of the patients and 42% of the carers reported that they did not sleep well, yet patients reported sleeping an average of 8.2 hours and carers 7.8 hours per night. The objective assessments revealed that although sleep efficiency (SE) was greater than 90% for most patients and carers, sleep fragmentation was high in both groups. Patients and carers who complained of poor sleep were significantly more anxious compared with patients and carers who reported sleeping well. Patients who complained of poor sleep had significantly more pain. These results show that a substantial proportion of advanced cancer patients and their carers complained of poor sleep despite reporting “normal” duration of sleep. Objective measurements using Actiwatch revealed good SE but high levels of sleep fragmentation and movement, suggesting that sleep quality may be disturbed. Health care professionals need to routinely inquire about sleep and consider possible reversible underlying factors, such as pain and anxiety, for those who report sleep disturbance.

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