Fatigue and Sleep Disturbance in Patients with Cancer, Patients with Clinical Depression, and Community-Dwelling Adults

Abstract

This study compared the severity of fatigue in patients with cancer to the fatigue reported by depressed psychiatric patients and community-dwelling adults. Data were collected for this study during the process of validating a new fatigue assessment tool, the Brief Fatigue Inventory (BFI). The sample included 354 cancer patients, 72 psychiatric patients, and 290 non-patient volunteers. Study subjects reported severity of fatigue and the degree to which fatigue interfered with various aspects of life. Data were also collected on sleep disturbance and demographic variables that might correlate with fatigue. The psychiatric patients reported significantly higher levels of fatigue and fatigue-related interference than the cancer patients, who reported more severe fatigue and interference than the community subjects. The sleep disturbance scores of the cancer patients and the community subjects were significantly correlated with fatigue severity. Although the majority of the psychiatric patients reported sleep disturbance, their sleep disturbance scores were not significantly associated with fatigue severity.

Psychometric evaluation of the Fatigue Severity Scale in patients with major depression

“…In our sample, the percentage of patients with clinically significant fatigue on the basis of the M.I.N.I. fatigue/energy loss item (79.2%) is in line with data from previous studies in depressed patients using various other fatigue measures [3,4,34]. The percentage of fatigue cases in the control sample (15.0%) is comparable to the ones (17.0-23.6%) recorded with other fatigue measures in previous community-based samples [34][35][36][37] although percentages as high as 38.0% have been reported [1].…”

Sleep disorders in advanced cancer patients: prevalence and factors associated

“…Higher depression scores were associated with problems in falling asleep, awaking during the night, difficulties in getting up in the morning, less sleep, and more frequent use of sleeping pills [10]. Although the majority of depressed patients reported sleep disturbances, their sleep disturbances were not associated with fatigue [3].…”

“…Fatigue, other than being a widespread debilitating effect of cancer in the advanced stage of disease, and its treatment, particularly after chemotherapy and radiotherapy treatments, may be the consequences of insomnia due to sleep deprivation of an underlying psychologic disturbance [2,6]. Sleep disturbance scores of cancer patients and community subjects were significantly correlated with fatigue severity [3]. This relationship is consistent with data reported in this study where, in patients with advanced disease, a relationship between fatigue and a low number of hours slept was found.…”

“…Epidemiological and clinical data, including performance status, habits, relevant symptoms, and drug use were recorded. Patients were asked to answer a small questionnaire containing different items commonly used in sleep studies [3], including in the psychometric evaluation of the Pittsburgh sleep quality index [4]. These questions addressed quantitative evaluation in terms of sleep duration, nocturnal and diurnalhours slept, or qualitative items such as falling asleep, awaking, getting back to sleep, early awaking, restoring sleep, nightmares, feeling depressed or anxious.…”

Effect of neutropenia on the impact of a cognitive‐behavioral intervention for symptom management

“…Symptom assessments among patients with cancer fall largely into one of two groups: those that focus on one or two symptoms over one or more sites of cancer, [15][16][17][18][19] or those that focus on multiple symptoms with a single site of cancer, and possibly different treatments (surgery vs. chemotherapy), and then describe the prevalence of multiple symptoms. 20 -24 The focus on one or two symptoms leaves open to question the co-occurrence of other symptoms and how they might influence variations in the severity of the one or two targeted symptoms.…”