Association of Nutrition Impact Symptoms With Sleep Disturbance Among Patients With Advanced Cancer Referred to...

ObjectivesWe investigated the associations of nutrition impact symptoms (NISs) with sleep disturbance among advanced cancer patients receiving palliative care.MethodsA secondary analysis of a self-administered survey was performed. Participants evaluated 3 components of sleep disturbance (ie, difficulty falling asleep, difficulty staying asleep, and early awakening) and 19 NISs using numerical rating scales (0-10). They also used several screening tools, including the Hospital Anxiety and Depression Scale (HADS). Finally, 2 groups were analyzed by multivariate logistic regression analysis using a cutoff score of 4 for each of the 3 components (< 4, lower score group; ≥ 4, higher score group).ResultsUltimately, 184 patients were included. For all 3 components, higher score groups had significantly greater numbers of NISs with a score ≥ 4 and higher anxiety and depression than lower score groups. In the logistic regression model using HADS-Anxiety for difficulty falling asleep, significantly higher adjusted odds ratios (ORs) were observed in the 4-6 NISs (with a score ≥ 4) group than in the no NISs (with a score ≥ 4) group (7.15 [95% confidence interval (CI), 1.24-41.06]). Using HADS-Depression for difficulty falling asleep and difficulty staying asleep, significantly higher adjusted ORs were observed in the 4-6 NISs group than in the no NISs group (7.43 [95% CI, 1.29-42.74]; 4.47 [95% CI, 1.02-19.69, respectively]).ConclusionsHaving 4 or more NISs with a score ≥ 4 was significantly associated with sleep disturbance. Cachexia-related symptom management is essential to improve patients' sleep status.