Self-reported sleep quality as prognostic for survival in lung cancer patients.

Purpose: Sleep is essential for life, as well as having a major impact on quality of life. Not much attention has been given to this important factor in the care of lung cancer patients.
Patients and Methods: We retrospectively analyzed a cohort of 404 lung cancer patients treated in our institute between 2010 and 2018. Data about sleep quality, distress and pain were self-reported by questionnaires administered to patients at their first clinic visit to the Institute of Oncology. Sex, age, histology, stage, smoking and marital status were extracted from the patients' charts. Uni- and multi-variate analyses were carried out to evaluate the correlation of these factors with survival.
Results: Most patients reported some level of distress and pain. Sleep abnormalities were reported by 58.7% of patients. Distress, pain and bad sleep were correlated with shorter survival in univariate analyses; however, only sleep remained associated with survival in multivariate analysis. Patients reporting bad sleep had a median survival of 16 months, compared to 27 months for patients reporting good sleep (hazard ratio 1.83, 95% C.I. 1.27-2.65). Frequent arousals at night were more tightly correlated with survival than difficulty falling asleep.
Conclusion: Sleep quality, as reported by lung cancer patients, is highly correlated with survival. Further studies are required to comprehend whether poor sleep quality is directly impacting survival or is a result of the cancer aggressiveness and patients' conditions.
Competing Interests: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. In the interest of full transparency: D.U. reports honoraria from Boehringer Ingelheim, Roche, BMS, MSD, Teva, AstraZeneca and Takeda. Y.R.L. reports research support from Checkmate Pharmaceuticals and BMS. A.O. reports research support from Boehringer Ingelheim, Roche, Sanofi-Aventis, Xcovery, AstraZeneca, BMS and MSD, advisory fees from Boehringer Ingelheim, MSD, Takeda and AstraZeneca, and honoraria from Takeda, Roche and Boehringer Ingelheim. J.B. reports honoraria from AstraZeneca, MSD, Boehringer Ingelheim, Roche, BMS, Takeda, Abbvie, Pfizer and VBL, and research support from MSD, AstraZeneca and Pfizer. All disclosures reported above are unrelated to the submitted work. All other authors declare no potential conflicts of interest in this work.
(© 2020 Gottfried et al.)