QOLP-36. THE IMPORTANCE OF SLEEP DISTURBANCE IN PRIMARY BRAIN TUMOR (PBT) PATIENTS: CLINICAL CHARACTERISTICS & CO-OCCURRENCE WITH TUMOR-RELATED & PSYCHOLOGICAL SYMPTOMS. (11th November 2019)

• Record Type: Journal Article
• Authors: King, Amanda; Shuboni-Mulligan, Dorela; Vera, Elizabeth; Crandon, Sonja; Aboud, Orwa; Antony, Ramya; Boris, Lisa; Bryla, Christine; Burton, Eric; Cordova, Christine; Gartland, Carrie; Grajkowska, Ewa; Penas-Prado, Marta; Reyes, Jennifer; Leggiero, Nicole; Siegel, Christine; Theeler, Brett; Wall, Kathleen; Wu, Jing; Gilbert, Mark; Armstrong, Terri
• Is Part Of: Neuro-oncology. Volume 21(2019)Supplement 6
• Page Start: vi205
• Page End: vi206
• Publication Date: 2019-11-11
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noz175.856
• Languages: English
• ISSNs: 1522-8517

Abstract

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.