CHICAGO – The prevalence of insomnia is roughly three times greater among cancer patients than it is among the general population, according to a secondary analysis of more than 500 patients.
The prevalence of insomnia that meets clinical criteria was 45.6% among cancer patients receiving chemotherapy, which compares with 19% in the general population. An additional 35% of cancer patients had insomnia symptoms, compared with 15% in the general population, reported Oxana Palesh, Ph.D., a radiation oncologist at the University of Rochester (N.Y.), at the annual meeting of the American Society of Clinical Oncology.
Roughly 80% of the patients continued to have insomnia problems throughout chemotherapy. “So insomnia does not go away on its own,” she said.
The researchers also found that the prevalence of insomnia was greatest among lung cancer patients (P less than .05). In addition, younger patients tended to have more insomnia (P less than .05). The researchers found no difference in the prevalence of insomnia between male and female cancer patients.
For the original study, 832 cancer patients were assessed during chemotherapy cycles 1 and 2.
Those found to have fatigue (547 patients) were randomized to receive either 20 mg paroxetine or placebo. Insomnia was assessed using the Hamilton Rating Scale for Depression (cycles 1, 2, 3, 4), and depression was assessed using the Center for Epidemiologic Studies-Depression scale. Fatigue was assessed using the Fatigue Symptom Checklist and the Multidimensional Assessment of Fatigue.
Patients were mostly female (72%) and white (89%), with a mean age of 57 years. Half had breast cancer, and overall 64% were undergoing adjuvant therapy. Fatigue and depression data were previously reported (J. Clin. Oncology 2003;21:4635-41). Although paroxetine did improve depressive symptoms, it had no effect on fatigue. In this analysis, the researchers reported that paroxetine had no significant effect on insomnia, compared with placebo.
Dr. Palesh reported that she has no relevant financial relationships.