The incidence of postoperative sleep disturbance and its influencing factors in cancer patients.

Abstract

Background: Sleep disturbances are a risk factor for poor prognosis, which is significantly related to postoperative recovery in cancer patients. In this cross-sectional study, we investigated the incidence of sleep disturbance in cancer patients after surgery and the associated risk factors.

Methods: 380 cancer patients who underwent elective surgery in the First Affiliated Hospital of Wenzhou Medical University from October 2021 to June 2023 were selected. According to the Pittsburgh Sleep Quality Index (PSQI) score, the patients were divided into a sleep disturbance group (PSQI ≥ 6 points) and a no sleep disturbance group (PSQI < 6 points). Univariate analysis was performed on the general data of patients, surgery-related complications, and factors related to the hospital environment. Based on clinical practice and univariate analysis, variables associated with sleep disturbance were selected for inclusion in a multivariable logistic regression model to identify independent risk factors and to develop a predictive model, which was evaluated in terms of discrimination and calibration.

Results: The incidence of postoperative sleep disturbance in cancer patients was 65.2 % (n = 193). Independent risk factors included preoperative sleep disturbance (OR [95 % CI]: 36.09 [15.59-83.53], P < 0.001), postoperative moderate to severe pain (OR [95 % CI]: 2.95 [1.19-7.30], P = 0.019), ward noise (OR [95 % CI]: 3.03 [1.41-6.52], P = 0.004), and postoperative anxiety (OR [95 % CI]: 9.07 [1.33-61.69], P = 0.024). Patients undergoing thoracic surgery had a lower risk of postoperative sleep disturbance compared to those undergoing thyroid or breast surgery (OR [95 % CI]: 0.27 [0.09-0.85], P = 0.024). Patients with high school education or above also had a lower incidence (OR [95 % CI]: 0.19 [0.08-0.50], P < 0.001).

Conclusions: The incidence of sleep disturbance in cancer patients after surgery was 65.2 %. Moderate to severe postoperative pain, postoperative anxiety, preoperative sleep disturbance, and ward noise are independent factors associated with postoperative sleep disturbance in cancer patients.