0907 Sleep Disturbances in Lung Cancer Patients Based on Patient Reported Outcomes and Polysomnography

Abstract Introduction Sleep disturbances are common in lung cancer patients, but comprehensive evaluations with patient-reported outcomes (PRO) and sleep evaluation with polysomnography (PSG) is lacking. Earlier studies described significant insomnia in this cohort. This study describes sleep disruption using PROs and PSG to identify underlying sleep disorders. Methods A retrospective review of lung cancer patients undergoing formal sleep evaluation from 4/1/2009 to 7/31/2014 was performed. Clinical characteristics, PROs using Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and PSG data were reviewed. Results 128 patients (58% men, median age 63 years, median BMI 29.9 kg/m2) were identified. Lung cancer stage was 40% early, 22% locally advanced and 38% metastatic disease, and most (48%) were undergoing active treatment. Comorbidities included hypertension (60%), COPD (42%), depression (16%) and anxiety (13%), and 59% were ever smokers. The majority (94%) were referred for sleep-related breathing disorder (SRBD). While 50% did not know when sleep disruption started in relation to their cancer, 33% report symptoms prior to cancer diagnosis, and 14% associate sleep disturbance after cancer diagnosis. Sleep aid use was reported by 26%, and pain medication use in 41%. In the 116 with ESS, daytime sleepiness was noted 56%. In the 101 with PSQI, 65% reported poor sleep. PSG was performed in 52%. Daytime sleepiness was inversely correlated with anxiety (OR 0.3, 95% CI 0.8 to 0.84). Poor sleep was associated with anxiety and COPD, but it was not significant. PROs did not have an impact on overall survival. Conclusion Sleep disturbances can contribute to symptom burden in lung cancer patients. Daytime sleepiness and poor sleep based on PROs was prevalent in our cohort. Although not significant, anxiety and COPD were associated with poor sleep, whereas daytime sleepiness was inversely associated with anxiety. Most of our patients had sleep-related breathing disorder while only a few had insomnia. Education about sleep health and proactive screening for sleep symptoms would be beneficial in lung cancer patients. Support (if any)