Background: Patients with head and neck cancer (HNC) undergoing radiation therapy (RT) often experience sleep disturbances that may contribute to oral mucositis (OM) and quality of life (QOL). Methods: Patients with HNC treated with RT at a single institution were examined. Sleep questionnaires were given on the first day of RT to assess for insomnia and obstructive sleep apnea (OSA). Patient-reported QOL and oral mucositis were assessed during RT. Associations between insomnia and OSA with QOL were assessed using the Mann–Whitney U test. Linear mixed models assessed associations with OM. Results: Among 87 patients, 34 patients (39%) had subthreshold or greater insomnia and 47 patients (54%) screened positive for OSA. Upon RT completion, patients with subthreshold or greater insomnia had worse physical function (p= 0.005), fatigue (p= 0.01), insomnia (p< 0.001), and sticky saliva (p= 0.002). Patients screening positive for OSA had worse physical function (p= 0.01), sticky saliva (p= 0.02), fatigue (p= 0.007), insomnia (p= 0.009), and pain (p= 0.005). Upon linear mixed model evaluation, subthreshold or greater insomnia (p= 0.01) and positive OSA screen (p= 0.002) were associated with worse OM. Conclusion: Insomnia and OSA are highly prevalent in patients with HNC undergoing RT. These sleep disturbances are associated with worse QOL and OM during treatment.
背景：接受放射治疗（RT）的头颈癌（HNC）患者常出现睡眠障碍，这可能加剧口腔黏膜炎（OM）并影响生活质量（QOL）。方法：对某单一机构接受RT的HNC患者进行研究。在RT首日通过睡眠问卷评估失眠和阻塞性睡眠呼吸暂停（OSA）情况。在RT期间评估患者报告的生活质量和口腔黏膜炎。采用Mann-Whitney U检验分析失眠及OSA与生活质量的关联性，通过线性混合模型评估其与口腔黏膜炎的相关性。结果：在87例患者中，34例（39%）存在阈下或更严重失眠，47例（54%）OSA筛查呈阳性。RT结束时，阈下或更严重失眠患者的躯体功能（p=0.005）、疲劳感（p=0.01）、失眠症状（p<0.001）及唾液黏稠度（p=0.002）显著恶化；OSA筛查阳性患者的躯体功能（p=0.01）、唾液黏稠度（p=0.02）、疲劳感（p=0.007）、失眠症状（p=0.009）及疼痛程度（p=0.005）显著加重。线性混合模型显示，阈下或更严重失眠（p=0.01）与OSA筛查阳性（p=0.002）均与更严重的口腔黏膜炎相关。结论：失眠与OSA在接受RT的HNC患者中普遍存在，这些睡眠障碍与治疗期间生活质量下降及口腔黏膜炎加重显著相关。
肿瘤(癌症)患者之家