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Sleep, Mood, and Quality of Life in Patients Receiving Treatment for Lung Cancer

Grace E. Dean
Nancy S. Redeker
Ya-Jung Wang
Ann E. Rogers
Suzanne S. Dickerson
Lynn M. Steinbrenner
Nalaka S. Gooneratne
ONF 2013, 40(5), 441-451 DOI: 10.1188/13.ONF.441-451

Purpose/Objectives: To distinguish relationships among subjective and objective characteristics of sleep, mood, and quality of life (QOL) in patients receiving treatment for lung cancer.

Design: Descriptive, correlational study.

Setting: Two ambulatory oncology clinics.

Sample: 35 patients with lung cancer.

Methods: The following instruments were used to measure the variables of interest: Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, Functional Assessment of Cancer Treatment-Lung (FACT-L), a sleep diary, and a motionlogger actigraph.

Main Research Variables: Sleep, mood, and QOL.

Findings: Significant differences were found between sleep diary and actigraph measures of sleep efficiency (p = 0.002), sleep latency (p = 0.014), sleep duration (p < 0.001), and wake after sleep onset (p < 0.001). Poor sleepers (PSQI score greater than 5) were significantly different from good sleepers (PSQI score of 5 or lower) on sleep diary measures of sleep efficiency and sleep latency and the FACT-L lung cancer symptom subscale, but not on mood or actigraphy sleep measures.

Conclusions: Although patients with lung cancer may report an overall acceptable sleep quality when assessed by a single question, those same patients may still have markedly increased sleep latencies or reduced total sleep time. The findings indicate the complexity of sleep disturbances in patients with lung cancer. Lung cancer symptoms had a stronger association with sleep than mood. Research using prospective methods will help to elucidate their clinical significance.

Implications for Nursing: Patients receiving treatment for lung cancer are at an increased risk for sleep disturbances and would benefit from routine sleep assessment and management. In addition, assessment and management of common symptoms may improve sleep and, ultimately, QOL.

Knowledge Translation: A high frequency of sleep disturbances in patients receiving treatment for lung cancer was evident, and poor sleepers had lower QOL. Sleep disturbances may be more related to lung cancer symptoms than anxiety or depression. Improving lung cancer symptoms such as dyspnea may improve sleep.

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