Survey on and analysis of the factors influencing the postoperative sleep quality of Chinese patients with oesophageal cancer.

Background: Sleep quality problems are common in patients with cancer, and the likelihood of sleep disorders is high in postoperative patients. Patients with oesophageal cancer are prone to postoperative problems with sleep quality owing to the complexity of the surgery. Therefore, we aimed to understand sleep quality of patients after oesophageal cancer surgery, analyse the factors that influence sleep quality, and provide theoretical references to improve the sleep quality of patients after oesophageal cancer surgery.

Methods: A self-designed general information questionnaire, the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale were used to conduct a questionnaire survey. This questionnaire was used to survey 119 patients who underwent oesophageal cancer surgery at our hospital's thoracic department from October 2020 to June 2021. Statistical methods such as Spearman correlation analysis and multiple regression analysis were used to analyse the sleep quality of the patients and explore the factors that influenced sleep quality.

Results: (1) Among the 119 postoperative oesophageal cancer patients included in the study, 116 patients (97.48%) experienced sleep disturbance (PSQI≥7). The mean PSQI scores were 15.19±3.95; 60.5% (72/119) of patients experienced anxiety, and 48.74% (58/119) experienced depression. (2) Spearman correlation analysis revealed that patients' sleep quality scores negatively correlated with level of education and surgical approach (correlation coefficients of -0.23 and -0.27, respectively, P<0.05) and positively correlated with pain scores and nutritional risk (correlation coefficients of 0.26 and 0.17, respectively, P<0.05). The results revealed no correlation between anxiety or depression scores and PSQI scores. The average monthly household income was correlated with level of education, home residence, a burden of medical expenses, postoperative complications, and anxiety scores (correlation coefficients were 0.17, -0.28, -0.47, 0.26, and-0.24, respectively; P<0.05). The burden of medical expenses was also correlated with level of education and home residence (the correlation coefficients were -0.16 and 0.22, respectively; P<0.05). Postoperative complications were positively correlated with anxiety scores and depression scores (correlation coefficients were 0.34 and 0.27, respectively, P<0.05). (3) Multiple regression analysis revealed that surgical approach, pain scores, level of education, and nutritional risk scores affect the sleep quality of patients (95% CI=9.83-17.48, adjusted R²=0.23, P<0.05).

Conclusions: The postoperative sleep quality of Chinese oesophageal cancer patients was generally poor, which was related to the surgical approach, education level, pain score, and nutritional risk score. Anxiety, depression scores, and average monthly household income may also indirectly affect sleep quality. These findings suggest that clinical caregivers should consider the above factors in the prevention and treatment of relevant symptoms to improve the sleep quality of patients.