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Willis KD, Reid MP, Fox A, Kleva CS, Sherwood P, Loughan AR. The impact of a primary brain tumor diagnosis on caregivers: Insights from the patients' perspective. Support Care Cancer 2024; 32:595. [PMID: 39160352 PMCID: PMC11333512 DOI: 10.1007/s00520-024-08783-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 08/02/2024] [Indexed: 08/21/2024]
Abstract
PURPOSE The diagnosis of a primary brain tumor (PBT) causes significant distress for the caregiver-patient dyad, warranting increased supportive care intervention. Although researchers have previously assessed caregivers' perceptions of their own supportive care needs, no study to date has identified how patients perceive the caregiving experience and/or patients' recommendations for integrating supportive care of caregivers in neuro-oncology. This qualitative study examined caregiver distress as well as caregiver supportive care needs from the patients' perspective to inform future intervention development. METHODS Adults with PBT (N = 15; Mage = 45; 53% female; 93% White) were divided into four, 90-min focus groups moderated by a clinical neuropsychologist. Patients responded to semi-structured interview questions regarding various supportive care needs throughout the course of disease. Each discussion was transcribed and coded using thematic content analysis and NVivo software. Inter-rater reliability was excellent (MKappa = 0.92, range = 0.85-0.93). RESULTS Seven distinct codes related to PBT caregivers emerged and were classified into two broader themes: Caregiver Impact (47% of coded content) and Caregiver Support (53% of coded content). Caregiver Impact refers to patients' perspective of the practical and emotional demands of caregiving. Under Caregiver Support, patients cited a strong need for increased support of caregivers, including bereavement care, individual psychotherapy, and joint caregiver-patient dyad sessions. CONCLUSION Patients with PBT expressed profound concerns regarding the demands of caregiving and its impact on the well-being of their loved ones. Findings emphasize the need for comprehensive dyadic support in neuro-oncology throughout the disease trajectory to enhance the overall quality-of-life for both patients and their caregivers.
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Affiliation(s)
- Kelcie D Willis
- Department of Psychiatry, Center for Psychiatric Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Morgan P Reid
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Amber Fox
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Christopher S Kleva
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Paula Sherwood
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashlee R Loughan
- Division of Neuro-Oncology, Department of Neurology, VCU School of Medicine, 1201 East Marshall St, Richmond, VA, 23298, USA.
- Massey Cancer Center, VCU School of Medicine, Richmond, VA, USA.
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Loughan AR, Lanoye A, Willis KD, Fox A, Ravyts SG, Zukas A, Kim Y. Telehealth group Cognitive-Behavioral Therapy for Insomnia (CBT-I) in primary brain tumor: Primary outcomes from a single-arm phase II feasibility and proof-of-concept trial. Neuro Oncol 2024; 26:516-527. [PMID: 37796017 PMCID: PMC10911999 DOI: 10.1093/neuonc/noad193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Cognitive-Behavioral Therapy for Insomnia (CBT-I), the frontline treatment for insomnia, has yet to be evaluated among patients with primary brain tumors (PwPBT) despite high prevalence of sleep disturbance in this population. This study aimed to be the first to evaluate the feasibility, safety, and acceptability of implementing telehealth group CBT-I as well as assessing preliminary changes in subjective sleep metrics in PwPBT from baseline to follow-up. METHODS Adult PwPBT were recruited to participate in six 90-min telehealth group CBT-I sessions. Feasibility was assessed by rates of screening, eligibility, enrollment, and data completion. Safety was measured by participant-reported adverse events. Acceptability was assessed by retention, session attendance, satisfaction, recommendation of program to others, and qualitative feedback. Participant subjective insomnia severity, sleep quality, and fatigue were assessed at baseline, post intervention, and 3-month follow-up. RESULTS Telehealth group CBT-I was deemed safe. Following the 76% screening rate, 85% of interested individuals met study eligibility and 98% enrolled (N = 44). Ninety-one percent of enrolled participants completed measures at baseline, 79% at post intervention, and 73% at 3-month follow-up. Overall, there was an 80% retention rate for the 6-session telehealth group CBT-I intervention. All participants endorsed moderate-to-strong treatment adherence and 97% reported improved sleep. Preliminary pre-post intervention effects demonstrated improvements in subjective insomnia severity, sleep quality, and fatigue with large effect sizes. These effects were maintained at follow-up. CONCLUSIONS Results of this proof-of-concept trial indicate that telehealth group CBT-I is feasible, safe, and acceptable among PwPBT, providing support for future randomized controlled pilot trials.
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Affiliation(s)
- Ashlee R Loughan
- Department of Neurology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Autumn Lanoye
- Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Internal Medicine, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kelcie D Willis
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Amber Fox
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Scott G Ravyts
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alicia Zukas
- Department of Neurosurgery, Medical College of South Carolina, Charleston, South Carolina, USA
| | - Youngdeok Kim
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia, USA
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Park JY, Kim MS, Ryu JM. Predictors of sleep quality components in patients undergoing transarterial chemoembolisation: a cross-sectional study. Support Care Cancer 2024; 32:149. [PMID: 38329591 DOI: 10.1007/s00520-024-08338-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/20/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Patients undergoing transarterial chemoembolisation experience postembolisation symptoms and interferences affecting sleep quality, which require intervention. The study aimed to identify the predictors of sleep quality components in patients undergoing transarterial chemoembolisation. METHODS This study included two groups of participants: 50 patients undergoing transarterial chemoembolisation and 45 nurses caring for them. Data were collected from September to November 2022 using a structured questionnaire, and analysed using descriptive statistics, the t-test, analysis of variance, Spearman's rank correlation, and multiple regression analysis using the SPSS 27.0 program (IBM Corp., Armonk, NY, USA). RESULTS The mean sleep quality score was 40.28±14.10. Heat sensation (t=-2.08, p=.043) and fatigue (t=-4.47, p<.001) predicted sleep fragmentation in 38.6% of the patients. Abdominal pain (t=-2.54, p=.014), vomiting (t=-2.21, p=.032), and the expected fatigue by the nurses (t=2.68, p=.014) predicted sleep length in 41.7% of patients. Abdominal pain (t=-2.05, p=.046) explained 42.9% of sleep depth. CONCLUSION Based on the predictors of sleep quality components obtained in this study, strategies to improve sleep quality tailored to patients undergoing transarterial chemoembolisation should be developed. This study highlighted the need to bridge the gap between patients' and nurses' expected fatigue and its contribution to sleep fragmentation and sleep length. It also highlighted the importance of noncontact temperature measurement, controlling vomiting, and pain relief for improving sleep length in patients undergoing transarterial chemoembolisation.
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Affiliation(s)
- Ji Young Park
- Gastrointestinal Surgery Ward, Pusan National University Hospital, Busan, South Korea
| | - Myoung Soo Kim
- Department of Nursing, Pukyong National University, 599-1, Daeyeon 3 dong, Namgu, Busan, 48513, South Korea.
| | - Jung Mi Ryu
- Department of Nursing, Busan Institute of Science and Technology, Busan, South Korea
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Shirokov A, Blokhina I, Fedosov I, Ilyukov E, Terskov A, Myagkov D, Tuktarov D, Tzoy M, Adushkina V, Zlatogosrkaya D, Evsyukova A, Telnova V, Dubrovsky A, Dmitrenko A, Manzhaeva M, Krupnova V, Tuzhilkin M, Elezarova I, Navolokin N, Saranceva E, Iskra T, Lykova E, Semyachkina-Glushkovskaya O. Different Effects of Phototherapy for Rat Glioma during Sleep and Wakefulness. Biomedicines 2024; 12:262. [PMID: 38397864 PMCID: PMC10886766 DOI: 10.3390/biomedicines12020262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
There is an association between sleep quality and glioma-specific outcomes, including survival. The critical role of sleep in survival among subjects with glioma may be due to sleep-induced activation of brain drainage (BD), that is dramatically suppressed in subjects with glioma. Emerging evidence demonstrates that photobiomodulation (PBM) is an effective technology for both the stimulation of BD and as an add-on therapy for glioma. Emerging evidence suggests that PBM during sleep stimulates BD more strongly than when awake. In this study on male Wistar rats, we clearly demonstrate that the PBM course during sleep vs. when awake more effectively suppresses glioma growth and increases survival compared with the control. The study of the mechanisms of this phenomenon revealed stronger effects of the PBM course in sleeping vs. awake rats on the stimulation of BD and an immune response against glioma, including an increase in the number of CD8+ in glioma cells, activation of apoptosis, and blockage of the proliferation of glioma cells. Our new technology for sleep-phototherapy opens a new strategy to improve the quality of medical care for patients with brain cancer, using promising smart-sleep and non-invasive approaches of glioma treatment.
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Affiliation(s)
- Alexander Shirokov
- Institute of Biochemistry and Physiology of Plants and Microorganisms, Saratov Scientific Centre of the Russian Academy of Sciences, Prospekt Entuziastov 13, 410049 Saratov, Russia
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Inna Blokhina
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Ivan Fedosov
- Physics Department, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.F.); (E.I.); (D.M.); (D.T.); (M.T.); (A.D.)
| | - Egor Ilyukov
- Physics Department, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.F.); (E.I.); (D.M.); (D.T.); (M.T.); (A.D.)
| | - Andrey Terskov
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Dmitry Myagkov
- Physics Department, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.F.); (E.I.); (D.M.); (D.T.); (M.T.); (A.D.)
| | - Dmitry Tuktarov
- Physics Department, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.F.); (E.I.); (D.M.); (D.T.); (M.T.); (A.D.)
| | - Maria Tzoy
- Physics Department, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.F.); (E.I.); (D.M.); (D.T.); (M.T.); (A.D.)
| | - Viktoria Adushkina
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Daria Zlatogosrkaya
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Arina Evsyukova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Valeria Telnova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Alexander Dubrovsky
- Physics Department, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.F.); (E.I.); (D.M.); (D.T.); (M.T.); (A.D.)
| | - Alexander Dmitrenko
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Maria Manzhaeva
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Valeria Krupnova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Matvey Tuzhilkin
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Inna Elezarova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Nikita Navolokin
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
- Department of Pathological Anatomy, Saratov Medical State University, Bolshaya Kazachaya Str. 112, 410012 Saratov, Russia
| | - Elena Saranceva
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Tatyana Iskra
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Ekaterina Lykova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
| | - Oxana Semyachkina-Glushkovskaya
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.B.); (A.T.); (V.A.); (D.Z.); (A.E.); (V.T.); (A.D.); (M.M.); (V.K.); (M.T.); (I.E.); (N.N.); (E.S.); (T.I.); (E.L.)
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
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Liu Y, Zhang X, Jiang M, Zhang Y, Wang C, Sun Y, Shi Z, Wang B. Impact of Preoperative Sleep Disturbances on Postoperative Delirium in Patients with Intracranial Tumors: A Prospective, Observational, Cohort Study. Nat Sci Sleep 2023; 15:1093-1105. [PMID: 38149043 PMCID: PMC10749794 DOI: 10.2147/nss.s432829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023] Open
Abstract
Background Postoperative delirium (POD) is prevalent in craniotomy patients and is associated with high mortality. Sleep disturbances are receiving increasing attention from clinicians as associated risk factors for postoperative complications. This study aimed to determine the impact of preoperative sleep disturbances on POD in craniotomy patients. Methods We recruited 130 patients undergoing elective craniotomy for intracranial tumors between May 1st and December 30th, 2022. Preoperative subjective sleep disturbances were assessed using the Pittsburgh Sleep Quality Index on the day of admission. We also measured objective perioperative sleep patterns using a dedicated sleep monitoring device 3 days before and 3 days after the surgery. POD was assessed twice daily using the Confusion Assessment Model for the Intensive Care Unit within the first week after craniotomy. Results Preoperative sleep disturbances were diagnosed in 49% of the study patients, and POD was diagnosed in 22% of all the study patients. Sleep disturbances were an independent risk factor for POD (OR: 2.709, 95% CI: 1.020-7.192, P = 0.045). Other risk factors for POD were age (OR: 3.038, 95% CI: 1.195-7.719, P = 0.020) and the duration of urinary catheterization (OR: 1.246, 95% CI: 1.025-1.513, P = 0.027). Perioperative sleep patterns (including sleep latency, deep sleep duration, frequency of awakenings, apnea-hypopnea index, and sleep efficiency) were significantly associated with POD. Conclusion This study demonstrated that preoperative sleep disturbances predispose patients undergoing craniotomy to POD, also inferred a correlation between perioperative sleep patterns and POD. The targeted screening and intervention specifically for sleep disturbances during the perioperative period are immensely required.
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Affiliation(s)
- Yang Liu
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, People’s Republic of China
| | - Xiaoyu Zhang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, People’s Republic of China
| | - Mengyang Jiang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, People’s Republic of China
| | - Yiqiang Zhang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, People’s Republic of China
| | - Chenhui Wang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, People’s Republic of China
| | - Yongxing Sun
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, People’s Republic of China
| | - Zhonghua Shi
- Department of Intensive Care Medicine, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, People’s Republic of China
| | - Baoguo Wang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, People’s Republic of China
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Sharma A. Palliative Care and Care Partner Support in Neuro-oncology. Continuum (Minneap Minn) 2023; 29:1872-1895. [PMID: 38085902 DOI: 10.1212/con.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
ABSTRACT The journey for a patient with a brain tumor and their loved ones can be extremely challenging due to the high burden of physical symptoms and the emotional distress caused by the diagnosis. Optimizing quality of life by addressing symptoms and reducing this emotional distress can improve treatment tolerance and outcomes and alleviate care partner distress and burden. Symptoms in patients with central nervous system (CNS) tumors can vary in onset and intensity, ranging from headaches, seizures, and focal weakness to emotional distress and cognitive dysfunction. Additionally, care partners may demonstrate distress due to the high burden of care and need appropriate support structures and access to resources to alleviate this stress. Evidence-based recommendations are unfortunately limited given the lack of high-quality research in this area, but patients living with CNS tumors and their loved ones can benefit from early and routine symptom identification and management, compassionate and transparent communication, and practical guidance for the future. These principles are part of palliative care, a field of medicine focused on alleviating suffering in patients with serious, chronic illness. Clinicians involved in the care of patients with CNS tumors must be educated in these important primary palliative care principles. This article focuses on key symptom management, strategies for high-quality communication, a discussion of advance care planning, and an overview of end-of-life care.
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Amidi A, Haldbo-Classen L, Kallehauge JF, Wu LM, Zachariae R, Lassen-Ramshad Y, Lukacova S, Høyer M. Radiation dose to sleep-relevant brain structures linked to impaired sleep quality in primary brain tumor patients. Acta Oncol 2023; 62:1520-1525. [PMID: 37688522 DOI: 10.1080/0284186x.2023.2249219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/10/2023] [Indexed: 09/11/2023]
Affiliation(s)
- Ali Amidi
- Department of Psychology & Behavioural Sciences, Sleep and Circadian Psychology Research Group, Aarhus University, Aarhus, Denmark
- Department of Oncology, Unit for Psycho-oncology & Health Psychology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Jesper F Kallehauge
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Lisa M Wu
- Department of Psychology & Behavioural Sciences, Sleep and Circadian Psychology Research Group, Aarhus University, Aarhus, Denmark
- Department of Oncology, Unit for Psycho-oncology & Health Psychology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Robert Zachariae
- Department of Psychology & Behavioural Sciences, Sleep and Circadian Psychology Research Group, Aarhus University, Aarhus, Denmark
- Department of Oncology, Unit for Psycho-oncology & Health Psychology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Slavka Lukacova
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Høyer
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
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8
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Liu Y, Wu F, Zhang X, Jiang M, Zhang Y, Wang C, Sun Y, Wang B. Associations between perioperative sleep patterns and clinical outcomes in patients with intracranial tumors: a correlation study. Front Neurol 2023; 14:1242360. [PMID: 37731854 PMCID: PMC10508910 DOI: 10.3389/fneur.2023.1242360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/09/2023] [Indexed: 09/22/2023] Open
Abstract
Objective Although the quality of perioperative sleep is gaining increasing attention in clinical recovery, its impact role remains unknown and may deserve further exploration. This study aimed to investigate the associations between perioperative sleep patterns and clinical outcomes among patients with intracranial tumors. Methods A correlation study was conducted in patients with intracranial tumors. Perioperative sleep patterns were assessed using a dedicated sleep monitor for 6 consecutive days. Clinical outcomes were gained through medical records and follow-up. Spearman's correlation coefficient and multiple linear regression analysis were applied to evaluate the associations between perioperative sleep patterns and clinical outcomes. Results Of 110 patients, 48 (43.6%) were men, with a median age of 57 years. A total of 618 days of data on perioperative sleep patterns were collected and analyzed. Multiple linear regression models revealed that the preoperative blood glucose was positively related to the preoperative frequency of awakenings (β = 0.125; 95% CI = 0.029-0.221; P = 0.011). The level of post-operative nausea and vomiting was negatively related to perioperative deep sleep time (β = -0.015; 95% CI = -0.027--0.003; P = 0.015). The level of anxiety and depression was negatively related to perioperative deep sleep time, respectively (β = -0.048; 95% CI = -0.089-0.008; P = 0.020, β = -0.041; 95% CI = -0.076-0.006; P = 0.021). The comprehensive complication index was positively related to the perioperative frequency of awakenings (β = 3.075; 95% CI = 1.080-5.070; P = 0.003). The post-operative length of stay was negatively related to perioperative deep sleep time (β = -0.067; 95% CI = -0.113-0.021; P = 0.005). The Pittsburgh Sleep Quality Index was positively related to perioperative sleep onset latency (β = 0.097; 95% CI = 0.044-0.150; P < 0.001) and negatively related to perioperative deep sleep time (β = -0.079; 95% CI = -0.122-0.035; P < 0.001). Conclusion Perioperative sleep patterns are associated with different clinical outcomes. Poor perioperative sleep quality, especially reduced deep sleep time, has a negative impact on clinical outcomes. Clinicians should, therefore, pay more attention to sleep quality and improve it during the perioperative period. Clinical trial registration http://www.chictr.org.cn, identifier: ChiCTR2200059425.
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Affiliation(s)
| | | | | | | | | | | | | | - Baoguo Wang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Allgood JE, Roe A, Sparks BB, Castillo M, Cruz A, Brooks AE, Brooks BD. The Correlation of Sleep Disturbance and Location of Glioma Tumors: A Narrative Review. J Clin Med 2023; 12:4058. [PMID: 37373751 DOI: 10.3390/jcm12124058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Sleep disturbance can occur when sleep centers of the brain, regions that are responsible for coordinating and generating healthy amounts of sleep, are disrupted by glioma growth or surgical resection. Several disorders cause disruptions to the average duration, quality, or patterns of sleep, resulting in sleep disturbance. It is unknown whether specific sleep disorders can be reliably correlated with glioma growth, but there are sufficient numbers of case reports to suggest that a connection is possible. In this manuscript, these case reports and retrospective chart reviews are considered in the context of the current primary literature on sleep disturbance and glioma diagnosis to identify a new and useful connection which warrants further systematic and scientific examination in preclinical animal models. Confirmation of the relationship between disruption of the sleep centers in the brain and glioma location could have significant implications for diagnostics, treatment, monitoring of metastasis/recurrence, and end-of-life considerations.
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Affiliation(s)
- JuliAnne E Allgood
- Department of Neuroscience, University of Wyoming, Laramie, WY 82071, USA
| | - Avery Roe
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
| | - Bridger B Sparks
- Department of Neuroscience, University of Wyoming, Laramie, WY 82071, USA
| | - Mercedes Castillo
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
| | - Angel Cruz
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
| | - Amanda E Brooks
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
| | - Benjamin D Brooks
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
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Loughan AR, Lanoye A, Willis KD, Ravyts SG, Fox A, Zukas A, Kim Y. Study protocol for Cognitive Behavioral Therapy for Insomnia in patients with primary brain tumor: A single-arm phase 2a proof-of-concept trial. Contemp Clin Trials Commun 2023; 32:101083. [PMID: 36879641 PMCID: PMC9984952 DOI: 10.1016/j.conctc.2023.101083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Background Sleep disturbance is among the most common symptoms endorsed by patients with primary brain tumor (PwPBT), with many reporting clinically elevated insomnia and poor management of their sleep-related symptoms by their medical team. Though Cognitive Behavioral Therapy for Insomnia (CBT-I) remains the front-line treatment for sleep disturbance, CBT-I has yet to be evaluated in PwPBT. Thus, it is unknown whether CBT-I is feasible, acceptable, or safe for patients with primary brain tumors. Methods PwPBT (N = 44) will enroll and participate in a six-week group-based CBT-I intervention delivered via telehealth. Feasibility will be based on pre-determined metrics of eligibility, rates and reasons for ineligibility, enrollment, and questionnaire completion. Acceptability will be measured by participant retention, session attendance, satisfaction ratings, and recommendation to others. Safety will be assessed by adverse event reporting. Sleep will be measured both objectively via wrist-worn actigraphy and subjectively via self-report. Participants will also complete psychosocial questionnaires at baseline, post-intervention, and three-month follow-up. Conclusion CBT-I, a non-pharmacological treatment option for insomnia, has the potential to be beneficial for an at-risk, underserved population: PwPBT. This trial will be the first to assess feasibility, acceptability, and safety of CBT-I in PwPBT. If successful, this protocol will be implemented in a more rigorous phase 2b randomized feasibility pilot with the aim of widespread implementation of CBT-I in neuro-oncology clinics.
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Affiliation(s)
- Ashlee R Loughan
- Virginia Commonwealth University, Department of Neurology, USA.,Virginia Commonwealth University, Massey Cancer Center, USA
| | - Autumn Lanoye
- Virginia Commonwealth University, Department of Health Behavior and Policy, USA.,Virginia Commonwealth University, Massey Cancer Center, USA
| | - Kelcie D Willis
- Virginia Commonwealth University, Department of Psychology, USA
| | - Scott G Ravyts
- Virginia Commonwealth University, Department of Psychology, USA
| | - Amber Fox
- Virginia Commonwealth University, Department of Psychology, USA
| | - Alicia Zukas
- Medical College of South Carolina, Department of Neurosurgery, USA
| | - Youngdeok Kim
- Virginia Commonwealth University, Department of Kinesiology and Health Sciences, Richmond, VA, USA
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Martin JA, Hart NH, Bradford N, Naumann F, Pinkham MB, Pinkham EP, Holland JJ. Prevalence and management of sleep disturbance in adults with primary brain tumours and their caregivers: a systematic review. J Neurooncol 2023; 162:25-44. [PMID: 36864318 PMCID: PMC10049936 DOI: 10.1007/s11060-023-04270-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/14/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE The aims of this systematic review were to (1) examine the prevalence, severity, manifestations, and clinical associations/risk factors of sleep disturbance in primary brain tumour (PBT) survivors and their caregivers; and (2) determine whether there are any sleep-focused interventons reported in the literature pertaining to people affected by PBT. METHODS This systematic review was registered with the international register for systematic reviews (PROSPERO: CRD42022299332). PubMed, EMBASE, Scopus, PsychINFO, and CINAHL were electronically searched for relevant articles reporting sleep disturbance and/or interventions for managing sleep disturbance published between September 2015 and May 2022. The search strategy included terms focusing on sleep disturbance, primary brain tumours, caregivers of PBT survivors, and interventions. Two reviewers conducted the quality appraisal (JBI Critical Appraisal Tools) independently, with results compared upon completion. RESULTS 34 manuscripts were eligible for inclusion. Sleep disturbance was highly prevalent in PBT survivors with associations between sleep disturbance and some treatments (e.g., surgical resection, radiotherapy, corticosteroid use), as well as other prevalent symptoms (e.g., fatigue, drowsiness, stress, pain). While the current review was unable to find any sleep-targeted interventions, preliminary evidence suggests physical activity may elicit beneficial change on subjectively reported sleep disturbance in PBT survivors. Only one manuscript that discussed caregivers sleep disturbance was identified. CONCLUSIONS Sleep disturbance is a prevalent symptom experienced by PBT survivors, yet there is a distinct lack of sleep-focused interventions in this population. This includes a need for future research to include caregivers, with only one study identified. Future research exploring interventions directly focused on the management of sleep disturbance in the context of PBT is warranted.
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Affiliation(s)
- Jason A Martin
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Australia.
| | - Nicolas H Hart
- Faculty of Health, School of Sport, Exercise and Rehabilitation, University of Technology Sydney (UTS), Sydney, Australia.,Faculty of Health, Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Australia.,School of Medical and Health Sciences, Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia.,College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, Australia.,Institute for Health Research, The University of Notre Dame Australia, Perth, Australia.,Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Natalie Bradford
- Faculty of Health, Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Australia
| | - Fiona Naumann
- Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Mark B Pinkham
- Radiation Oncology, Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Elizabeth P Pinkham
- Physiotherapy, Clinical Support Services, Princess Alexandra Hospital, Brisbane, Australia.,Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Justin J Holland
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Australia
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