Geriatric Sleep Research Program
Sleep Patterns in Patients with Advanced Lung Cancer
There has been a growing awareness of the importance and benefit of hospice care for the terminally ill. While pain and depression detract from quality of life, studies have identified that poor sleep and concomitant daytime fatigue also have a profoundly negative impact on these patients. While it is recognized as a factor, to date there have been no studies which have attempted to identify the determinants of sleep disruption in hospice patients. Furthermore, there has been no documentation of the correlation between subjectively reported sleep quality and objective measures of sleep efficiency—a key consideration when determining the correct clinical approach to treating patients with self-reports of poor sleep. We anticipate that pain, dyspnea, and nausea will increase insomnia because of discomfort. Depression, which often occurs in hospice patients, will also exacerbate sleep fragmentation. Melatonin is one of the output markers of the suprachiasmatic nucleus, the putative site of the intrinsic circadian pacemaker, thus we anticipate that there will be changes in the amplitude of its secretion in patients with insomnia.
In this study, we plan to prospectively follow palliative lung cancer patients (advanced lung cancer) in order to develop an explanatory model for sleep disruption in terminal cancer patients. We anticipate that major determinants of poor sleep quality will be pain, depression, dyspnea, gastro-intestinal complaints, inadequate light exposure and abnormal melatonin rhythms.
Funding AgencyDepartment of Veterans Affairs
Nalaka Gooneratne, Principal Investigator
Liz Roben, research coordinator
Sumedha Chhatre, biostatistician