Association between Poor Sleep Quality with Anxiety and Depression Scores among Patients with Urological Cancers
-
Pantea Arya
,
Zeinab Ahadi
,
Alireza Khajavi
,
Seyed Saeed Tamehri Zadeh
,
Elahe Pourhosein
,
Seyed Mohammad Kazem Aghamir
Abstract
Background and Objective: It has been postulated that patients with cancer experience various degrees of poor sleep quality at different points of disease courses. On the other hand, a high proportion of patients with cancer present symp-toms of anxiety and depression. The purpose of the study was to assess the association of sleep quality with anxiety and depression in patients with urological cancers.
Materials and Methods: The present study was a cross-sectional study performed in the Cancer Registry Center at Tehran University of Medical Sciences, Tehran, Iran, in 2019-2020. For eligible patients, demographic data were collected from their records, and Pittsburgh Sleep Quality Index (PSQI) questionnaire, Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Rating Scale for Depression (HAM-D) were completed for each patient.
Results: The mean + SD age of participants was 64.1 ± 14.5 years, and the most of patients were male (90.1%). In total, 142 patients were enrolled in the study, and 92 patients (64.8%) were categorized as patients with poor sleep quality. The mean global score was 7.85 ± 3.94, and the mean of anxiety and depression was 10.85 ± 6.80 and 15.30 ± 4.90, respectively. The regression analysis showed that for one-unit increase in sleep quality score, the anxiety score signifi-cantly increased by 0.98 unit [95% confidence interval (CI): 0.74-1.22, P < 0.001], and for depression significantly increased by 0.69 unit (95% CI: 0.52-0.87, P < 0.001).
Conclusion: More than half of our patients suffer from poor sleep quality, associated with anxiety and depression symptoms.
1. Shin DW, Park HS, Lee SH, et al. Health-related quality of life, perceived social support, and depression in disease-free survivors who underwent curative surgery only for prostate, kidney and bladder cancer: comparison among survivors and with the general population. Cancer Res Treat 2019; 51: 289-99.
2. Basiri A, Shakhssalim N, Jalaly NY, et al. Difference in the incidences of the most prevalent urologic cancers from 2003 to 2009 in Iran. Asian Pac J Cancer Prev 2014; 15: 1459-63.
3. Pishgar F, Amini E, Gohari K, et al. National and subnational mortality of urological cancers in Iran, 1990-2015. Asia Pac J Clin Oncol 2019; 15: e43-e48.
4. Watts S, Leydon G, Birch B, et al. Depression and anxiety in prostate cancer: A systematic review and meta-analysis of prevalence rates. BMJ Open 2014; 4: e003901.
5. Echchikhi Y, el Abbassi S, Touil A, et al. Sleep disorders and sleep quality in moroccan adult patients with cancer during treatment. J Cancer Sci Ther 2017; 9: 637-43.
6. Symonds P, Lord KW, Mitchell AJ. Life After urological cancer–psychological issues. In: Nargund VH, Raghavan D, Sandler HM, editors. Urological oncology. London, UK: Springer London; 2015. p. 323-36.
7. Barichello E, Sawada NO, Sonobe HM, et al. Quality of sleep in postoperative surgical oncologic patients. Rev Latino-am Enfermagem 2009; 17: 481-8.
8. Fann JR, Thomas-Rich AM, Katon WJ, et al. Major depression after breast cancer: A review of epidemiology and treatment. Gen Hosp Psychiatry 2008; 30: 112-26.
9.Irwin MR, Olmstead RE, Ganz PA, et al. Sleep disturbance, inflammation and depression risk in cancer survivors. Brain Behav Immun 2013; 30 Suppl: S58-S67.
10. Dirksen SR, Epstein DR, Hoyt MA. Insomnia, de-pression, and distress among outpatients with prostate cancer. Appl Nurs Res 2009; 22: 154-8.
11. Miaskowski C, Paul SM, Cooper BA, et al. Predictors of the trajectories of self-reported sleep disturbance in men with prostate cancer during and following radiation therapy. Sleep 2011; 34: 171-9.
12. Miller AH, Ancoli-Israel S, Bower JE, et al. Neuro-endocrine-immune mechanisms of behavioral comorbidities in patients with cancer. J Clin Oncol 2008; 26: 971-82.
13. Rooney AG, McNamara S, Mackinnon M, et al. Frequency, clinical associations, and longitudinal course of major depressive disorder in adults with cerebral glioma. J Clin Oncol 2011; 29: 4307-12.
14. Groenvold M, Petersen MA, Idler E, et al. Psycho-logical distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Res Treat 2007; 105: 209-19.
15. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160: 2101-7.
16. Pasquini M, Biondi M. Depression in cancer patients: A critical review. Clin Pract Epidemiol Ment Health 2007; 3: 2.
17. Buysse DJ, Reynolds CF, III, Monk TH, et al. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193-213.
18. Bruno RM, Palagini L, Gemignani A, et al. Poor sleep quality and resistant hypertension. Sleep Med 2013; 14: 1157-63.
19. Matsuda R, Kohno T, Kohsaka S, et al. The prevalence of poor sleep quality and its association with depression and anxiety scores in patients admitted for cardiovascular disease: A cross-sectional designed study. Int J Cardiol 2017; 228: 977-82.
20. Farrahi MJ, Nakhaee N, Sheibani V, et al. Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath 2012; 16: 79-82.
21. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32: 50-5.
22. Matza LS, Morlock R, Sexton C, et al. Identifying HAM-A cutoffs for mild, moderate, and severe generalized anxiety disorder. Int J Methods Psychiatr Res 2010; 19: 223-32.
23. Hamilton M. The Hamilton Rating Scale for Depression. In: Sartorius N, Ban TA, editors. Assessment of Depression. Berlin, Heidelberg: Springer Berlin Heidelberg; 1986. p. 143-52.
24. Riedel M, Moller HJ, Obermeier M, et al. Response and remission criteria in major depression--a validation of current practice. J Psychiatr Res 2010; 44: 1063-8.
25. Mystakidou K, Parpa E, Tsilika E, et al. Sleep quality in advanced cancer patients. J Psychosom Res 2007; 62: 527-33.
26. Byles JE, Mishra GD, Harris MA. The experience of insomnia among older women. Sleep 2005; 28: 972-9.
27. Savard J, Simard S, Hervouet S, et al. Insomnia in men treated with radical prostatectomy for prostate cancer. Psychooncology 2005; 14: 147-56.
28. Savard J, Morin CM. Insomnia in the context of cancer: A review of a neglected problem. J Clin Oncol 2001; 19: 895-908.
29. Davidson JR, MacLean AW, Brundage MD, et al. Sleep disturbance in cancer patients. Soc Sci Med 2002; 54: 1309-21.
30. Davis MP, Khoshknabi D, Walsh D, et al. Insomnia in patients with advanced cancer. Am J Hosp Palliat Care 2014; 31: 365-73.
31. Akman T, Yavuzsen T, Sevgen Z, et al. Evaluation of sleep disorders in cancer patients based on Pittsburgh Sleep Quality Index. Eur J Cancer Care (Engl) 2015; 24: 553-9.
32. Ramsawh HJ, Stein MB, Belik SL, et al. Relation-ship of anxiety disorders, sleep quality, and functional impairment in a community sample. J Psychiatr Res 2009; 43: 926-33.
33. Potvin O, Lorrain D, Belleville G, et al. Subjective sleep characteristics associated with anxiety and depression in older adults: A population-based study. Int J Geriatr Psychiatry 2014; 29: 1262-70.
34. Mystakidou K, Parpa E, Tsilika E, et al. How is sleep quality affected by the psychological and symptom distress of advanced cancer patients? Palliat Med 2009; 23: 46-53.
35. Irwin MR. Why sleep is important for health: A psychoneuroimmunology perspective. Annu Rev Psychol 2015; 66: 143-72.
36. Gold PW. The organization of the stress system and its dysregulation in depressive illness. Mol Psychiatry 2015; 20: 32-47.
37. Besedovsky L, Lange T, Born J. Sleep and immune function. Pflugers Arch 2012; 463: 121-37.
38. Lutgendorf SK, Weinrib AZ, Penedo F, et al. Inter-leukin-6, cortisol, and depressive symptoms in ovarian cancer patients. J Clin Oncol 2008; 26: 4820-7.
39. Sephton SE, Dhabhar FS, Keuroghlian AS, et al. Depression, cortisol, and suppressed cell-mediated immunity in metastatic breast cancer. Brain Behav Immun 2009; 23: 1148-55.
2. Basiri A, Shakhssalim N, Jalaly NY, et al. Difference in the incidences of the most prevalent urologic cancers from 2003 to 2009 in Iran. Asian Pac J Cancer Prev 2014; 15: 1459-63.
3. Pishgar F, Amini E, Gohari K, et al. National and subnational mortality of urological cancers in Iran, 1990-2015. Asia Pac J Clin Oncol 2019; 15: e43-e48.
4. Watts S, Leydon G, Birch B, et al. Depression and anxiety in prostate cancer: A systematic review and meta-analysis of prevalence rates. BMJ Open 2014; 4: e003901.
5. Echchikhi Y, el Abbassi S, Touil A, et al. Sleep disorders and sleep quality in moroccan adult patients with cancer during treatment. J Cancer Sci Ther 2017; 9: 637-43.
6. Symonds P, Lord KW, Mitchell AJ. Life After urological cancer–psychological issues. In: Nargund VH, Raghavan D, Sandler HM, editors. Urological oncology. London, UK: Springer London; 2015. p. 323-36.
7. Barichello E, Sawada NO, Sonobe HM, et al. Quality of sleep in postoperative surgical oncologic patients. Rev Latino-am Enfermagem 2009; 17: 481-8.
8. Fann JR, Thomas-Rich AM, Katon WJ, et al. Major depression after breast cancer: A review of epidemiology and treatment. Gen Hosp Psychiatry 2008; 30: 112-26.
9.Irwin MR, Olmstead RE, Ganz PA, et al. Sleep disturbance, inflammation and depression risk in cancer survivors. Brain Behav Immun 2013; 30 Suppl: S58-S67.
10. Dirksen SR, Epstein DR, Hoyt MA. Insomnia, de-pression, and distress among outpatients with prostate cancer. Appl Nurs Res 2009; 22: 154-8.
11. Miaskowski C, Paul SM, Cooper BA, et al. Predictors of the trajectories of self-reported sleep disturbance in men with prostate cancer during and following radiation therapy. Sleep 2011; 34: 171-9.
12. Miller AH, Ancoli-Israel S, Bower JE, et al. Neuro-endocrine-immune mechanisms of behavioral comorbidities in patients with cancer. J Clin Oncol 2008; 26: 971-82.
13. Rooney AG, McNamara S, Mackinnon M, et al. Frequency, clinical associations, and longitudinal course of major depressive disorder in adults with cerebral glioma. J Clin Oncol 2011; 29: 4307-12.
14. Groenvold M, Petersen MA, Idler E, et al. Psycho-logical distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Res Treat 2007; 105: 209-19.
15. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160: 2101-7.
16. Pasquini M, Biondi M. Depression in cancer patients: A critical review. Clin Pract Epidemiol Ment Health 2007; 3: 2.
17. Buysse DJ, Reynolds CF, III, Monk TH, et al. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193-213.
18. Bruno RM, Palagini L, Gemignani A, et al. Poor sleep quality and resistant hypertension. Sleep Med 2013; 14: 1157-63.
19. Matsuda R, Kohno T, Kohsaka S, et al. The prevalence of poor sleep quality and its association with depression and anxiety scores in patients admitted for cardiovascular disease: A cross-sectional designed study. Int J Cardiol 2017; 228: 977-82.
20. Farrahi MJ, Nakhaee N, Sheibani V, et al. Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath 2012; 16: 79-82.
21. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32: 50-5.
22. Matza LS, Morlock R, Sexton C, et al. Identifying HAM-A cutoffs for mild, moderate, and severe generalized anxiety disorder. Int J Methods Psychiatr Res 2010; 19: 223-32.
23. Hamilton M. The Hamilton Rating Scale for Depression. In: Sartorius N, Ban TA, editors. Assessment of Depression. Berlin, Heidelberg: Springer Berlin Heidelberg; 1986. p. 143-52.
24. Riedel M, Moller HJ, Obermeier M, et al. Response and remission criteria in major depression--a validation of current practice. J Psychiatr Res 2010; 44: 1063-8.
25. Mystakidou K, Parpa E, Tsilika E, et al. Sleep quality in advanced cancer patients. J Psychosom Res 2007; 62: 527-33.
26. Byles JE, Mishra GD, Harris MA. The experience of insomnia among older women. Sleep 2005; 28: 972-9.
27. Savard J, Simard S, Hervouet S, et al. Insomnia in men treated with radical prostatectomy for prostate cancer. Psychooncology 2005; 14: 147-56.
28. Savard J, Morin CM. Insomnia in the context of cancer: A review of a neglected problem. J Clin Oncol 2001; 19: 895-908.
29. Davidson JR, MacLean AW, Brundage MD, et al. Sleep disturbance in cancer patients. Soc Sci Med 2002; 54: 1309-21.
30. Davis MP, Khoshknabi D, Walsh D, et al. Insomnia in patients with advanced cancer. Am J Hosp Palliat Care 2014; 31: 365-73.
31. Akman T, Yavuzsen T, Sevgen Z, et al. Evaluation of sleep disorders in cancer patients based on Pittsburgh Sleep Quality Index. Eur J Cancer Care (Engl) 2015; 24: 553-9.
32. Ramsawh HJ, Stein MB, Belik SL, et al. Relation-ship of anxiety disorders, sleep quality, and functional impairment in a community sample. J Psychiatr Res 2009; 43: 926-33.
33. Potvin O, Lorrain D, Belleville G, et al. Subjective sleep characteristics associated with anxiety and depression in older adults: A population-based study. Int J Geriatr Psychiatry 2014; 29: 1262-70.
34. Mystakidou K, Parpa E, Tsilika E, et al. How is sleep quality affected by the psychological and symptom distress of advanced cancer patients? Palliat Med 2009; 23: 46-53.
35. Irwin MR. Why sleep is important for health: A psychoneuroimmunology perspective. Annu Rev Psychol 2015; 66: 143-72.
36. Gold PW. The organization of the stress system and its dysregulation in depressive illness. Mol Psychiatry 2015; 20: 32-47.
37. Besedovsky L, Lange T, Born J. Sleep and immune function. Pflugers Arch 2012; 463: 121-37.
38. Lutgendorf SK, Weinrib AZ, Penedo F, et al. Inter-leukin-6, cortisol, and depressive symptoms in ovarian cancer patients. J Clin Oncol 2008; 26: 4820-7.
39. Sephton SE, Dhabhar FS, Keuroghlian AS, et al. Depression, cortisol, and suppressed cell-mediated immunity in metastatic breast cancer. Brain Behav Immun 2009; 23: 1148-55.
| Files | ||
| Issue | Vol 6 No 1-2 (2021): Winter-Spring | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jss.v6i(1-2).9293 | |
| Keywords | ||
| Sleep quality Anxiety Depression Cancer Urology | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Arya P, Ahadi Z, Khajavi A, Tamehri Zadeh SS, Pourhosein E, Aghamir SMK. Association between Poor Sleep Quality with Anxiety and Depression Scores among Patients with Urological Cancers. J Sleep Sci. 2022;6(1-2):41-47.
