Sleeping-related distress in a palliative care population : A national, prospective, consecutive cohort
Currow, David C. ; Davis, Walter ; Connolly, Alanna ; Krishnan, Anu ; Wong, Aaron ; Webster, Andrew ; Barnes-Harris, Matilda M.M. ; Daveson, Barb and Ekström, Magnus LU
(2021)
In Palliative Medicine
35(9).
p.1663-1670
- Abstract
Background: Sleep, a multi-dimensional experience, is essential for optimal physical and mental wellbeing. Poor sleep is associated with worse wellbeing but data are scarce from multi-site studies on sleeping-related distress in palliative care populations. Aim: To evaluate patient-reported distress related to sleep and explore key demographic and symptom distress related to pain, breathing or fatigue. Design: Australian national, consecutive cohort study with prospectively collected point-of-care data using symptoms from the Symptom Assessment Scale (SAS). Setting/Participants: People (n = 118,117; 475,298 phases of care) who died while being seen by specialist palliative care services (n = 152) 2013–2019. Settings: inpatient (direct... (More)
Background: Sleep, a multi-dimensional experience, is essential for optimal physical and mental wellbeing. Poor sleep is associated with worse wellbeing but data are scarce from multi-site studies on sleeping-related distress in palliative care populations. Aim: To evaluate patient-reported distress related to sleep and explore key demographic and symptom distress related to pain, breathing or fatigue. Design: Australian national, consecutive cohort study with prospectively collected point-of-care data using symptoms from the Symptom Assessment Scale (SAS). Setting/Participants: People (n = 118,117; 475,298 phases of care) who died while being seen by specialist palliative care services (n = 152) 2013–2019. Settings: inpatient (direct care, consultative); community (outpatient clinics, home, residential aged care). Results: Moderate/severe levels of sleeping-related distress were reported in 11.9% of assessments, more frequently by males (12.7% vs 10.9% females); people aged <50 years (16.2% vs 11.5%); and people with cancer (12.3% vs 10.0% for other diagnoses). Sleeping-related distress peaked with mid-range Australia-modified Karnofsky Performance Status scores (40–60). Strong associations existed between pain-, breathing- and fatigue-related distress in people who identified moderate/severe sleeping-related distress, adjusted for age, sex and functional status. Those reporting moderate/severe sleeping-related distress were also more likely to experience severe pain-related distress (adjusted odds ratios [OR] 6.6; 95% confidence interval (CI) 6.3, 6.9); breathing-related distress (OR 6.2; 95% CI 5.8, 6.6); and fatigue-related distress (OR 10.4; 95% CI 9.99–10.8). Conclusions: This large, representative study of palliative care patients shows high prevalence of sleeping-related distress, with strong associations shown to distress from other symptoms including pain, breathlessness and fatigue.
(Less)
- author
- Currow, David C.
; Davis, Walter
; Connolly, Alanna
; Krishnan, Anu
; Wong, Aaron
; Webster, Andrew
; Barnes-Harris, Matilda M.M.
; Daveson, Barb
and Ekström, Magnus
LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Palliative care, prospective cohort study, sleep, symptom cluster, symptom control
- in
- Palliative Medicine
- volume
- 35
- issue
- 9
- pages
- 1663 - 1670
- publisher
- SAGE Publications
- external identifiers
-
- pmid:33726609
- scopus:85102702529
- ISSN
- 0269-2163
- DOI
- 10.1177/0269216321998558
- language
- English
- LU publication?
- yes
- id
- 6d42e395-ef79-487c-ac0b-e0731f94e38a
- date added to LUP
- 2021-04-06 11:13:25
- date last changed
- 2025-01-26 08:30:42
@article{6d42e395-ef79-487c-ac0b-e0731f94e38a,
abstract = {{<p>Background: Sleep, a multi-dimensional experience, is essential for optimal physical and mental wellbeing. Poor sleep is associated with worse wellbeing but data are scarce from multi-site studies on sleeping-related distress in palliative care populations. Aim: To evaluate patient-reported distress related to sleep and explore key demographic and symptom distress related to pain, breathing or fatigue. Design: Australian national, consecutive cohort study with prospectively collected point-of-care data using symptoms from the Symptom Assessment Scale (SAS). Setting/Participants: People (n = 118,117; 475,298 phases of care) who died while being seen by specialist palliative care services (n = 152) 2013–2019. Settings: inpatient (direct care, consultative); community (outpatient clinics, home, residential aged care). Results: Moderate/severe levels of sleeping-related distress were reported in 11.9% of assessments, more frequently by males (12.7% vs 10.9% females); people aged <50 years (16.2% vs 11.5%); and people with cancer (12.3% vs 10.0% for other diagnoses). Sleeping-related distress peaked with mid-range Australia-modified Karnofsky Performance Status scores (40–60). Strong associations existed between pain-, breathing- and fatigue-related distress in people who identified moderate/severe sleeping-related distress, adjusted for age, sex and functional status. Those reporting moderate/severe sleeping-related distress were also more likely to experience severe pain-related distress (adjusted odds ratios [OR] 6.6; 95% confidence interval (CI) 6.3, 6.9); breathing-related distress (OR 6.2; 95% CI 5.8, 6.6); and fatigue-related distress (OR 10.4; 95% CI 9.99–10.8). Conclusions: This large, representative study of palliative care patients shows high prevalence of sleeping-related distress, with strong associations shown to distress from other symptoms including pain, breathlessness and fatigue.</p>}},
author = {{Currow, David C. and Davis, Walter and Connolly, Alanna and Krishnan, Anu and Wong, Aaron and Webster, Andrew and Barnes-Harris, Matilda M.M. and Daveson, Barb and Ekström, Magnus}},
issn = {{0269-2163}},
keywords = {{Palliative care; prospective cohort study; sleep; symptom cluster; symptom control}},
language = {{eng}},
number = {{9}},
pages = {{1663--1670}},
publisher = {{SAGE Publications}},
series = {{Palliative Medicine}},
title = {{Sleeping-related distress in a palliative care population : A national, prospective, consecutive cohort}},
url = {{http://dx.doi.org/10.1177/0269216321998558}},
doi = {{10.1177/0269216321998558}},
volume = {{35}},
year = {{2021}},
}