0902 Increased Sleep Disruption in Patients with Advanced Cancer Undergoing Immunotherapy

Abstract Introduction Sleep disruption is common in patients with advanced cancer. In addition to cancer-related factors, therapies such as chemotherapy, hormonal therapy and radiation may contribute to poor sleep. The role of immunotherapy in sleep disturbance is not well-studied; however, sparse evidence suggests that better sleep quality may improve clinical outcomes and reduce immunotherapy-related toxicity. We conducted a study to evaluate self-reported sleep in patients with advanced cancer receiving immunotherapy to better characterize their sleep quality. Methods We reviewed 250 patients sequentially undergoing immunotherapy in a single tertiary cancer center for advanced cancer from February 2020 to February 2022. The Pittsburgh Sleep Quality Index (PSQI) was used to quantify self-reported sleep quality. Individual components were assessed to gain a holistic picture of the patients’ perceptions of their sleep. Results The global PSQI score was greater than 5 in 75 of 250 patients (30%), signifying overall poor sleep. Mean global PSQI score was 6.97 with a standard deviation of 3.87 and a standard error of 0.24. Analysis of the other components of the PSQI revealed mild impairment of sleep efficiency, increased daytime sleepiness and decreased motivation. The mean score for sleep aid use was 0.94, indicating sleep aid use less than once a week. Notably, the mean score of self-reported sleep perception was 0.791 with a standard deviation of 0.716, indicating overall satisfaction with sleep quality. Conclusion To our knowledge, this is the largest series to characterize self-reported sleep disruption in patients with advanced cancer receiving immunotherapy. Our results show that there is significant sleep aid use and sleep disruption in up to 30% of patients receiving immunotherapy. There was notable discordance between self-reported perception of sleep and the global PSQI score. This may be due to lower expectations for quality sleep on the part of the patients, given cancer burden and other comorbidities. If so, routine sleep assessment and specialist evaluation is imperative to improve quality of life and assure these patients that a better quality of sleep is possible. Further studies are indicated to characterize sleep architecture in these patients and assess correlation with clinical outcomes such as tumor response and adverse event rates. Support (if any)