Associations of Pain, Anxiety, and Depressive Symptoms With Sleep Outcomes in Patients With Head and Neck Squamous Cell Carcinoma: A Cross-Sectional Observational Study.

IF 2.3 3区 医学 Q1 OTORHINOLARYNGOLOGY
Giseli Mitsuy Kayahara, Bruna Amélia Moreira Sarafim-Costa, Marcus Vinícius Branco de Oliveira, Antônio Mendes Fontanelli, Yi Ye, Vitor Bonetti Valente, Eder Ricardo Biasoli, Glauco Issamu Miyahara, Daniel Galera Bernabé
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Abstract

Background: This exploratory cross-sectional observational study sought to characterize sleep quality and evaluate its association with sociodemographic, clinicopathological, behavioral, and psychological variables in patients with head and neck squamous cell carcinoma (HNSCC).

Patients and methods: Sleep problems from 132 HNC patients were assessed before starting oncological treatment through the questionnaires Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and STOP-Bang. Anxiety and depression symptoms were evaluated using the Hospital Anxiety and Depression Scale. Univariate analysis and multivariate logistic regression were performed to evaluate factors associated with sleep problems in HNSCC patients.

Results: About 50% of the HNSCC patients reported poor overall sleep quality on the PSQI. Insomnia, excessive daytime sleepiness, and high risk of apnea were observed in 19%, 15%, and 54% of HNSCC patients, respectively. Our results showed that pain was associated with overall poor PSQI sleep quality and lower PSQI sleep efficiency, while the presence of regional metastasis was linked to overall PSQI good sleep. No other clinicopathological or behavioral (i.e., alcohol and tobacco use) variables were related to sleep outcomes. Higher occurrence of anxiety symptoms was related to poor overall PSQI sleep quality, decreased PSQI sleep efficiency, PSQI daytime dysfunction, and ISI insomnia. Moreover, higher occurrence of depression symptoms was associated with lower PSQI sleep latency and PSQI duration, and the occurrence of ESS excessive daytime sleepiness.

Conclusion: Pain, anxiety, and depressive symptoms were associated with poor sleep quality and sleep problems in HNSCC patients before starting treatment. No sociodemographic or behavioral (i.e., alcohol and tobacco use) variables were related to sleep outcomes. Likewise, tumor location, T classification, and clinical staging were not linked to sleep quality and disorders in HNSCC patients.

头颈部鳞状细胞癌患者疼痛、焦虑和抑郁症状与睡眠结果的关联:一项横断面观察性研究
背景:本探索性横断面观察性研究旨在描述头颈部鳞状细胞癌(HNSCC)患者的睡眠质量特征,并评估其与社会人口学、临床病理、行为和心理变量的关系。患者和方法:采用匹兹堡睡眠质量指数(PSQI)、失眠严重程度指数(ISI)、Epworth嗜睡量表(ESS)和STOP-Bang问卷对132例HNC患者在肿瘤治疗前的睡眠问题进行评估。使用医院焦虑抑郁量表评估焦虑和抑郁症状。采用单因素分析和多因素logistic回归评价HNSCC患者睡眠问题的相关因素。结果:约50%的HNSCC患者在PSQI中报告整体睡眠质量较差。19%、15%和54%的HNSCC患者存在失眠、白天过度嗜睡和呼吸暂停高风险。我们的研究结果表明,疼痛与整体PSQI睡眠质量差和PSQI睡眠效率低有关,而区域转移的存在与整体PSQI睡眠良好有关。没有其他临床病理或行为(即酒精和烟草使用)变量与睡眠结果相关。焦虑症状的高发生率与PSQI整体睡眠质量差、PSQI睡眠效率下降、PSQI日间功能障碍和ISI失眠有关。此外,抑郁症状的高发生率与PSQI睡眠潜伏期和PSQI持续时间较低以及ESS白天过度嗜睡的发生有关。结论:治疗前HNSCC患者的疼痛、焦虑和抑郁症状与睡眠质量差和睡眠问题相关。没有社会人口学或行为(即酒精和烟草使用)变量与睡眠结果相关。同样,肿瘤位置、T分类和临床分期与HNSCC患者的睡眠质量和障碍无关。
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来源期刊
CiteScore
7.00
自引率
6.90%
发文量
278
审稿时长
1.6 months
期刊介绍: Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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