Sanjay R. Jain

Sleep-wake disturbances and quality of life in patients with advanced lung cancer.

PURPOSE/OBJECTIVES To examine the scope and severity of subjective sleep-wake disturbances in patients with lung cancer and compare them to a group of healthy adults who were similar in age, gender, and race, and to examine the impact of sleep-wake disturbances on measures of health-related quality of life (QOL). DESIGN Descriptive, comparative. SETTING University-based and private urban ambulatory care clinics. SAMPLE 43 patients with advanced non-small cell or small cell lung cancer and 36 healthy adults. All participants were cognitively intact, and none had any known neurologic disorder, polysomnographically diagnosed sleep disorder, mood or anxiety disorders, or cerebral metastasis. METHODS Questionnaires, interview, and medical record review. MAIN RESEARCH VARIABLES Nocturnal sleep (quality, quantity, and disturbance), daytime sleepiness, and health-related QOL (physical, mental). FINDINGS Patients with lung cancer had poor perceived nocturnal sleep quality and excessive daytime sleepiness that differed significantly from the comparison group. Sleep disturbances in the group with lung cancer were characterized by breathing difficulty, cough, nocturia, and frequent awakenings. Sleep-wake disturbances were significantly associated with poorer health-related QOL after controlling for group. Excessive daytime sleepiness was associated most often with decreases in mental health, whereas poor nocturnal sleep was associated most often with decreases in physical health. CONCLUSIONS Findings suggest that sleep-wake disturbances are common in patients with lung cancer and that the disturbances are significantly associated with health-related QOL. Patients with lung cancer may be at risk for sleep-disordered breathing. IMPLICATIONS FOR NURSING The magnitude of nocturnal sleep disturbance and daytime sleepiness identified in this study reinforces the importance of ongoing screening and effective intervention for sleep-wake disturbances in patients with lung cancer.

Counties eliminating racial disparities in colorectal cancer mortality.

Although colorectal cancer (CRC) mortality rates are declining, racial‐ethnic disparities in CRC mortality nationally are widening. Herein, the authors attempted to identify county‐level variations in this pattern, and to characterize counties with improving disparity trends.