Sleep Quality in Lung Cancer Patients

  • Published : 2013.05.30


Background: The aim of this study was to determine factors affecting sleep quality of 100 patients with advanced stage lung cancer. Methods and Results: it was a descriptive study. A variety of assessment tools were used to provide sleep scores to examine the relation between adverse effects caused by the treatment (nausea, vomiting, fatigue) and sleep quality. As a result, no statistically significant relation between coughing and respiratory problems of patients, or existing depression, and average sleep quality score was found (KW:0.872, p=0.646, KW: 3.174, p=0.205, u: 441.000 p=0.916). It was revealed that nausea and loss of appetite experienced also did not affect the sleep quality score (p>0.05), whereas problems such as vomiting and fatigue did exert effects (p<0.01). Conclusions: Patients with advanced stage lung cancer suffer from sleep problems and cancer related symptoms also affect their sleep quality negatively. Nurses should plan interventions that can control symptoms such as pain, vomiting and fatigue, which affect the sleep of patients.


  1. Akechi T, Okuyama T, Akizuki N, et al (2007). Associated and predictive factors of sleep disturbance in advanced cancer patients. Psycho-Oncology, 16, 888-94.
  2. Albayrak S (2006). Sleep Disorders in Patients with Lung Cancer.Thesis, Izmir, Turkey.
  3. Anderson KO, Getto CJ, Mendoza TR, et al (2003). Fatigue and sleep disturbance in patients with cancer, patients with clinical depression, and community dwelling adults. J Pain and Symp Manag, 25, 307-18.
  4. Aynur A, DeclanW, Rybicki L (2010). Review: symptom clusters: myth or reality. Palliat Med, 24, 373-85.
  5. Beck SL, Dudley WN, Barsevick A (2005). Pain, sleep disturbance, and fatigue in patients with cancer: using a mediation model to test asymptom cluster. Oncol Nurs For, 32, 48-55.
  6. Berger AM, Parker KP, Young-McCaughan S, et al (2005). Sleep wake disturbances in people with cancer and their caregivers: state of the science. Oncol Nurs Forum, 32, 98-126.
  7. Bergkvist K, Wengstrom Y (2005). Symptom experiences during chemotherapy treatment-with focus on nausea and vomiting. Eur J Oncol Nurs, 10, 21-9.
  8. Chen LM, Chang KH (2004). Physical symptom profiles of depressed and nondepressed patients with cancer. Palliat Med, 18, 712-8.
  9. Cheng KKF, Lee DTF (2011). Effects of pain, fatigue, insomnia, and mood disturbance on functional status and quality of life of elderly patients with cancer. Oncology Hematology, 78, 127-37.
  10. Davidson JR, Maclean AW, Brundage MD, Schulze K (2002). Sleep Disturbance In Cancer Patients. Social Sci and Med, 54, 1309-21.
  11. Donovan KA, Jacobsen PB (2007). Fatigue, depression, and insomnia: evidence for a symptom cluster in cancer. Semin in Oncol Nurs, 23, 127-35.
  12. Eyigor S, Eyigor C, Uslu R (2010). Assessment of pain, fatigue, sleep and quality of life (QQL) in elderly hospitalized cancer patients. Archiv Geront and Geriatri, 51, 57-61.
  13. Faubert J, Vaessen G (2005). Nausea: the neglected symptom? Eur J Oncol Nurs, 9, 21-32.
  14. Foley KL, Farmer DF, Petronis VM, et al (2006). A qualitative exploration of the cancer. experience among long-term survivors:comparisons by cancer type, ethnicity, gender, and age. Psycho-Oncology, 15, 248-58.
  15. Fortner B, Stepanski EJ, Wang SC, Kasprowicz S, Durrence HH (2002). Sleep and quality of life in breast cancer patients. J Pain Symptom Manage, 24, 471-80.
  16. Gooneratne NS, Dean GE, Rogers AE, et al (2007). Sleep and quality of life in long-term lung cancer survivors. Lung Cancer, 58, 403-10.
  17. Gorguner M (2007). Lung Cancer. Turkish Torax Association Professional Development Course 2007; Ankara, Turkey.
  18. Guay MD, Yennurajalingam S, Parsons H, Palmer JL, Bruera E (2011). Association between self-reported sleep disturbance and other symptoms in patients with advanced cancer. J Pain Symptom Manage, 41, 819-27.
  19. Herbert M, Johns MW, Dore C (1976). Factor analysis of analogue scales measuring subjective feelings before and sleep. Br J Med Psych, 49, 373-49.
  20. Hsiang Y, Tsai YF, Lai YH, Tsai CM (2008). Fatigue experience and coping Strategies in Taiwanese lung cancer patients receiving chemotherapy. J Clinical Nurs, 17, 876-83.
  21. Israel AS (2001). The relationship between fatique and sleep in cancer patients: a review. Eur J Cancer Care, 10, 245-55.
  22. Joyce M, Schwartz S, Huhmann M (2008). Supportive care in lung cancer. Semin Oncology Nurs, 24, 57-67.
  23. Kvale EA, Shuster JL (2006). Sleep disturbance in supportive care of cancer: a review. Palliat Med, 9, 437-51.
  24. Lianqi L (2008). Sleep disturbances in cancer. Psychiatric Ann, 38, 627-34.
  25. Lis CG, Gupta D, Grutsch JF (2008). The relationship between insomnia and patient satisfaction with quality of life in cancer. Support Care Cancer, 16, 261-6.
  26. Lui SL, Ng F, Lo WK (2002). Factors associated with sleep disorders in chinese patients on continuous ambulatory peritoneal dialysis. Perit Dialy İnter, 22, 677-682.
  27. Lutz S, Norrell R, Bertucio C, et al (2001). Symptom frequency and severity in patients with metastatic or locally recurrent lung cancer: a prospective study using the lung cancer symptom scale in a community hospital. Palliat Med, 4, 157-65.
  28. McMillan SC, Tofthagen C, Morgan MA (2008). Relationships among pain, sleep disturbances, and depressive symptoms in outpatients from a comprehensive cancer center. Oncol Nurs For, 35, 603-11.
  29. Mercadante S, Gireli D, Casuccio A (2004). Sleep Disorders In Advanced Cancer Patients:Prevalence And Factors Associated". Support Care Cancer, 12, 355-9.
  30. Moore P, Dimsdale JE (2002). Opioids, sleep and cancer-related fatigue. Medical Hypotheses, 58, 77-82.
  31. Myastakidou, K, Parpa E, Tsilika E, et al (2007). Sleep quality in advanced cancer patients. Psychosomatic Research, 62, 527-33.
  32. Mystakidou K, Parpa E, Tsilika E, et al (2009). How is sleep quality affected by the psychological and symptom distress of advanced cancer patients? Palliat Med, 23, 46-53.
  33. O'Donnell JF (2004). Insomnia in cancer patients. Clin Cornerstoner, 6, 6-14.
  34. Okuyama T, Akechi T, Kugaya A. et al (2000). Factors correlated with fatigue in disease-free breast cancer patients: application of the cancer fatigue scale. Support Care Cancer, 3, 215-22.
  35. Parrot AC, Hindmarch I (1980). The leeds sleep evaluation questionnaire in psychopharmacological investigations- a review. Psychopharmacology, 71, 173-9.
  36. Redeker NS, Lev EL, Ruggiero J (2000). Insomnia, fatigue, anxiety, depression, and quality of life of cancer patients undergoing chemotherapy. Schol Inquir Nurs Prac, 14, 275-90.
  37. Redyy SK, Parsons HK, Elsayem A, Palmer JL, Bruera E (2009). Characteristics and correlates of dyspnea in patients with advanced cancer. J Palliat Med, 12, 29-36.
  38. Roscoe JA, Kaufman ME, Matteson-Rusby SE, et al (2007). Cancer-related fatigue and sleep disorders. Oncologist, 12, 35-42.
  39. Savard J, Ivers H, Villa J, Caplette-Gingras A, Morin CM (2011). Natural course of insomnia comorbid with cancer: an 18-month longitudinal study. J Clin Oncol, 29, 3580-6.
  40. Savard J, Morin CM (2001). Insomnia in the context of cancer: A review of a neglected problem. J Clin Oncol, 19, 895-908.
  41. Sela RA, Wantanabe S, Nekolaichuc CL (2005). Sleep disturbances in palliative cancer patients attending a pain and symtom control clinic. Palliat and Supp Care, 3, 23-31.
  42. Shuanglan L, Chen Y, Yang L, Zhou J (2013). Pain, fatigue, disturbed sleep and distress comprised a symptom cluster that related to quality of life and functional status of lung cancer surgery patients. J Clin Nurs, 22, 1281-90.
  43. Tanaka K, Akechi T, Okuyama T, Nishiwaki Y, Uchitomi Y (2002). Impact of dyspnea, pain, and fatigue on daily life activities in ambulatory patients with advanced lung cancer. J Pain and Symp Manag, 23, 417-23.
  44. Theobald ED (2004). Cancer pain, fatigue, distress, and insomnia in cancer patients. Clin Cornerstone, 6, 15-21.
  45. Vena C, Parker K, Allen R, et al (2006). Sleepwake disturbances and quality of life in patients with advanced lung cancer. Oncol Nurs Forum, 33, 761-9.
  46. Wender R, Fontham TH, Barrera E, et al (2013). American Cancer Society lung cancer screening guidelines. CA Cancer J Clin, 63, 106-17.
  47. Whitmer MK, Pruemer JM, Nahleh ZA, Jazieh AR (2006). Symptom management needs of oncology outpatients. Palliat Med, 9, 628-30.
  48. Yale DP, Tami RB, Marianna K, Gwen U, Betty RF (2007). Symptom concerns and resource utilization in patients with lung cancer. Palliat Med, 10, 899-903.
  49. Yavuzsen T, Komurcu s (2008). Evaluation of fatigue symptoms and associated clinical problems in patients with cancer. Gulhane Medical Journal, 50, 141-6.
  50. Yildirim YK, Uyar M, Uslu R (2006). Tools for Evaluating cancer pain. Cancer and Palliative Care, 45-50, Izmir, Turkey.
  51. Zarogoulidis P, Steiropoulos P, Perantoni E, et al (2013). Subjective sleep quality in lung cancer patients before and after chemotherapy. Thoracic Cancer, 4, 138-42.

Cited by

  1. Phase II Study on EANI Combined with Hydrochloride Palonosetron for Prevention of Chemotherapy-induced Nausea and Vomiting Following Highly Emetogenic Chemotherapy vol.15, pp.9, 2014,
  2. Short Sleep Duration and Its Correlates among Cancer Survivors in Korea: the Korea National Health and Nutrition Examination Surveys vol.16, pp.11, 2015,
  3. Incorporating measures of sleep quality into cancer studies vol.23, pp.4, 2015,