Short-term insomnia symptom profile transitions in older patients with cancer pain

Insomnia symptoms are common in older adults with cancer pain and may fluctuate during hospitalization. This longitudinal study explored short-term changes in insomnia symptom profiles in 238 patients aged 60 years or older across two assessments conducted within 48 h of hospital admission and again 7-10 days after treatment initiation. Using the Athens Insomnia Scale, we identified four profiles: minimal or no insomnia symptoms, daytime dysfunction, low sleep efficiency, and high insomnia symptoms. Profile membership showed short-term reclassification, with the High Insomnia Symptoms profile remaining relatively stable and some patients with milder or domain-specific symptoms moving to more severe profiles. Higher baseline pain, fatigue, and anxiety were associated with an increased likelihood of short-term worsening in insomnia symptom profiles, whereas lower pain burden and better physical performance were associated with more favorable insomnia profiles. These findings highlight heterogeneous, short-term fluctuations in insomnia symptoms among older patients with cancer pain.