Sleep disturbance in adults with untreated primary brain tumors: prevalence and impact on quality of life

Pei-Ching Lin; Pin-Yuan Chen; Kuo-Chen Wei; Jian-Her Lin; Mei-Ru Lin; Huan-Chih Wang; Hsiao-Yean Chiu

doi:10.1007/s41105-022-00436-y

Sleep disturbance in adults with untreated primary brain tumors: prevalence and impact on quality of life

Sleep Biol Rhythms. 2022 Dec 10;21(2):201-209. doi: 10.1007/s41105-022-00436-y. eCollection 2023 Apr.

Authors

Pei-Ching Lin^#^{1

2}, Pin-Yuan Chen^#^{3

4

5}, Kuo-Chen Wei⁶, Jian-Her Lin^{7

8

9

10}, Mei-Ru Lin^{1

11}, Huan-Chih Wang^{12

13}, Hsiao-Yean Chiu^{1

14

15

16}

Affiliations

¹ School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wuxing St., Xinyi Dist., Taipei City, 110 Taiwan.
² Department of Neurosurgery, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan.
³ Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung, Taiwan.
⁴ School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁵ Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
⁶ Department of Neurosurgery, New Taipei City Municipal Tucheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei, Taiwan.
⁷ Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
⁸ Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan.
⁹ Department of Surgery, School of Medicine, Taipei Medical University, Taipei, Taiwan.
¹⁰ Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.
¹¹ Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
¹² Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.
¹³ Department of Neurosurgery, National Taiwan University Hospital, Taipei, Taiwan.
¹⁴ Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.
¹⁵ Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
¹⁶ Department of Psychiatry and Sleep Center, Taipei Medical University Hospital, Taipei, Taiwan.

^# Contributed equally.

Abstract

Purpose: To investigate the frequency of sleep disturbance and its effects on quality of life in adults with untreated primary brain tumors.

Methods: This cross-sectional study recruited 68 and 35 patients with newly diagnosed benign and malignant brain tumors, respectively. All participants completed the Chinese versions of the Athens Insomnia Scale, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, Brief Fatigue Inventory, and EORTC-QLQ-BN20 for quality-of-life assessment. An actigraph was used to measure sleep parameters [e.g., dichotomy index (I < O)], for at least 3 consecutive days in untreated status.

Results: The majority of the patients with benign and malignant tumors had meningioma (57.4%) and glioblastoma (40%), respectively. The prevalence of insomnia, poor sleep quality, and excessive daytime sleepiness was 59.2%, 77.7%, and 4.9%, respectively. The prevalence rates of sleep disturbances were not affected by tumor locations (suprasellar vs. non-suprasellar tumors) and tumor types (benign vs. malignant tumors). Only 36 participants completed actigraphy assessments (I < O = 95.4) due to having a tight schedule, actigraph malfunction, or not having the habit of wearing a wristwatch; 61% of them experienced circadian rhythm disruption (I < O ≤ 97.5). Insomnia was the only sleep parameter that significantly affected quality of life after controlling for potential confounders (B = 0.54, p = 0.03, adjusted R² = 0.60).

Conclusion: More than 60% of the patients with primary malignant and benign brain tumors experienced insomnia, poor sleep quality, and circadian rhythm disruption. Insomnia was independently correlated with quality of life in untreated status. Health-care providers can apply these findings to design effective interventions targeting sleep disturbance to improve quality of life in this population.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-022-00436-y.

Keywords: Circadian rhythm; Primary brain tumors; Quality of life; Sleep disturbance.

© The Author(s), under exclusive licence to Japanese Society of Sleep Research 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.