Sleep Pattern Changes in patients with lung cancer (original) (raw)

Background: There are multiple connections between sleep and lung cancer. Both of them impacting each other lung cancer can make it difficult to sleep well due to symptoms and treatment side effects(20-70% of cancer patients suffer of insomnia) .Also there is possible relationship between lung cancer and nocturnal intermittent hypoxia, apnea and daytime sleepiness, progression of lung cancer considered as risk factor of obstructive sleep apnea severity. Aim of the work: to evaluate sleep pattern changes in patients with lung cancer. Patients and methods: 26 patients with non small cell lung cancer were interviewed for assessment of histopathological subtypes and stages according to TNM classification and treated at Department of Clinical Oncology and Nuclear Medicine (chemotherapy, radiotherapy, targeted therapy and surgical treatment were scheduled), they underwent to sleep questionnaire and Epworth Sleepiness Score (ESS).overnight full polysomnography was done. Results: A prospective cohort study 26 lung cancer patients were enrolled in this study, 84.6% of the studied patients were on 4073 chemotherapy, 34.6% were on targeted therapy, 19.2% on radiotherapy and 7.7% received surgical treatment.38.5% of the studied patients were stage 3, 23.1% were stage 2, 38.5% were stage 4. After had ESS 42.3%of the studied patients were excessively situational sleepy and 15.4% of them were normal sleep. Sleep latency was 52.535± 60.077 min; the mean of sleep efficiency was 45.9% ±18.5%; the mean of wakefulness after sleep onset /minute (WASO) was 107.06± 0.61.94. The mean of total apnea-hypopnea Index/hour (AHI) was 27.61± 27.45 all reading are (OSA), Desaturation Index/hour was 23.44± 23.075, Arousal Index/ hour was 27.25± 14.72; Snoring Episodes was 27.25± 46.05. PLMS/ hour (periodic limb movements) was 54.71± 69.50. 23 ∕26 patients (88.5%) were obstructive sleep apnea (OSA), 8/23 (34.9) were mild OSAS, 9/23(39.1%) were moderate OSAS and 6/23 (26.1%) were sever OSAS. 21 ∕ 26 patients (80.8%) had sleep maintenance insomnia. The mean of OAS (overall survival) was 18.38±11.426, there is a positive correlation between OAS and sleep efficiency, % in the studied patients (r = 0.435, P = 0.026), there is a negative correlation between OAS and total AHI hour in the studied patients, ESS and snoring episodes (r = 0.622, P = 0.001), (r = 0.411, P = 0.037), (r = 0.637, P = 0.001). Conclusion: Patients with lung cancer had inefficient sleep, delay sleep latency (insomnia) and had sleep respiratory breathing disorders (OSAS). Tumor size and tumor staging affect OSA severity. OAS inversely correlated to OSA severity.