Journal des troubles du sommeil et de la thérapie
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Subjective and Objective Measures of Sleep Quality in Advanced Cancer: A Possible Clinical Marker for Depression

Michael J Hasselberg*, Anton P Porsteinsson, Lisa Boyle1 and Kathy P Parker

Purpose: It is estimated that between 30 and 75% of patients with cancer experience depression, poor nocturnal sleep, and daytime sleepiness. Research designed to specifically examine associations of depression with subjective and objective sleep measures is lacking. Thus the purpose of these analyses was to compare relationships among depression, subjective and polysomnographic measures of sleep.

Methods: Secondary data analysis design was used to assess sleep quality, and self-rated depression of patients with advanced cancer recruited from a university-based medical system. Responses to the Beck Depression Inventory-II (BDI-II), Pittsburgh Sleep Questionnaire Index (PSQI), and the Epworth Sleepiness Scale (ESS), and polysomnography data were analyzed using descriptive, correlation, and regression statistics. Results: A total of 114 patients with advanced cancer completed the study. PSQI and ESS scores were positively correlated with BDI-II scores. Total nocturnal sleep time and a prolonged REM latency were also positively related to BDI-II scores. When controlling for selected demographic and clinical features, the relationships between polysomnographic variables and depression were no longer significant.

Conclusions: Depression was related to subjective sleep quality and daytime sleepiness suggesting that these problems occur together. In addition, higher levels of depression were associated with nocturnal sleep time and prolonged REM latency.