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Sleep disruption among cancer patients following autologous hematopoietic cell transplantation

Bone Marrow Transplantation volume 53, pages 307–314 (2018)Cite this article

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Abstract

Despite a high prevalence of sleep disruption among hematopoietic cell transplant (HCT) recipients, relatively little research has investigated its relationships with modifiable cognitive or behavioral factors or used actigraphy to characterize sleep disruption in this population. Autologous HCT recipients who were 6–18 months post transplant completed self-report measures of cancer-related distress, fear of cancer recurrence, dysfunctional sleep cognitions, and inhibitory sleep behaviors upon enrollment. Patients then wore an actigraph for 7 days and completed a self-report measure of sleep disruption on day 7 of the study. Among the 84 participants (age M = 60, 45% female), 41% reported clinically relevant sleep disruption. Examination of actigraph data confirmed that, on average, sleep was disrupted (wake after sleep onset M = 66 min) and sleep efficiency was less than recommended (sleep efficiency M = 78%). Cancer-related distress, fear of recurrence, dysfunctional sleep cognitions, and inhibitory sleep behaviors were related to self-reported sleep disruption (p values<0.05) but not objective sleep indices. Results suggest that many HCT recipients experience sleep disruption after transplant. Cancer-related distress, fear of recurrence, dysfunctional sleep cognitions, and maladaptive sleep behaviors are related to self-reported sleep disruption and should be considered targets for cognitive behavioral intervention in this population.

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Acknowledgments

We would like to thank the patients who participated in this study. This work was supported in part by the Survey Methods Core Facility at the H. Lee Moffitt Cancer Center and Research Institute, an NCI-designated Comprehensive Cancer Center (P30-CA076292).  This work was performed while Dr. Jacobsen was at the Moffitt Cancer Center and does not represent the views of NIH.

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Authors and Affiliations

  1. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA

    Ashley M. Nelson, Heather S. L. Jim, Brian D. Gonzalez, Julie M. Cessna & Kelly A. Hyland

  2. Department of Psychology, University of South Florida, Tampa, FL, USA

    Ashley M. Nelson, Julie M. Cessna & Kelly A. Hyland

  3. School of Aging Studies, University of South Florida, Tampa, FL, USA

    Brent J. Small

  4. Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL, USA

    Taiga Nishihori

  5. Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA

    Meredith E. Rumble

  6. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA

    Paul B. Jacobsen

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Correspondence to Heather S. L. Jim.

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Nelson, A.M., Jim, H.S.L., Small, B.J. et al. Sleep disruption among cancer patients following autologous hematopoietic cell transplantation. Bone Marrow Transplant 53, 307–314 (2018). https://doi.org/10.1038/s41409-017-0022-3

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