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Amanda King, Dorela Shuboni-Mulligan, Elizabeth Vera, Sonja Crandon, Orwa Aboud, Ramya Antony, Lisa Boris, Christine Bryla, Eric Burton, Christine Cordova, Carrie Gartland, Ewa Grajkowska, Marta Penas-Prado, Jennifer Reyes, Nicole Leggiero, Christine Siegel, Brett Theeler, Kathleen Wall, Jing Wu, Mark Gilbert, Terri Armstrong, QOLP-36. THE IMPORTANCE OF SLEEP DISTURBANCE IN PRIMARY BRAIN TUMOR (PBT) PATIENTS: CLINICAL CHARACTERISTICS & CO-OCCURRENCE WITH TUMOR-RELATED & PSYCHOLOGICAL SYMPTOMS, Neuro-Oncology, Volume 21, Issue Supplement_6, November 2019, Pages vi205–vi206, https://doi.org/10.1093/neuonc/noz175.856
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Abstract
Sleep disturbance (SD) is a common symptom reported by PBT patients and research has demonstrated a link between sleep and stress circadian pathways. SD can impact perceived severity of other symptoms and development of psychopathology. This study explored the prevalence of moderate-severe SD in PBT patients, identifying associated clinical characteristics and co-occurrence with other tumor-related and psychological symptoms. Demographic, clinical characteristics, MDASI-Brain Tumor, and PROMIS Depression and Anxiety Short-Forms were collected at study entry. Descriptive statistics, Chi-square tests, and independent t-tests were used to report results. The sample included 424 patients (58% male, 81% Caucasian) with a median age of 49 years (range 18–81) and 58% with high-grade gliomas. Most had received treatment with surgery, radiation or chemotherapy prior to study entry, with 44% reporting a past recurrence. Moderate-severe SD (³ 5 on a 0–10 scale) was reported in 19% of patients and was associated with younger age (mean difference = 5 years), poor KPS (OR 2.2), current steroid use (OR 2.4), and tumor progression on MRI (OR 2). Those with moderate-severe SD had a higher overall symptom burden (mean difference = 2.3) and reported more moderate-severe symptoms (8 vs. 2). Patients reporting moderate-severe SD also reported higher severity in affective and cognitive symptom domains and mood-interference, with fatigue (72%), drowsiness (59%), and distress (56%) the most frequently co-occurring symptoms. Patients with moderate-severe SD also had increased prevalence of moderate-severe anxiety (32%) and depression (23%), compared to 10% in those without SD. PBT patients with moderate-severe SD are more symptomatic and have higher incidence of mood disturbance, suggesting a key role for sleep in the development of tumor-related and psychological symptoms. Future work delineating specific pathways involving sleep disturbance and co-occurring symptoms will be foundational for designing targeted sleep interventions to improve symptom burden and quality of life.
- anxiety
- magnetic resonance imaging
- chemotherapy regimen
- fatigue
- demography
- depressive disorders
- dyssomnias
- glioma
- neurobehavioral manifestations
- psychopathology
- sleep disorders
- steroids
- surgical procedures, operative
- european continental ancestry group
- brain
- neoplasms
- quality of life
- sleep
- stress
- surgery specialty
- mood
- drowsiness
- mood disturbances
- tumor progression
- descriptive statistics