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Cancer-related insomnia: Evaluation by mobile technology.

107 Background: Insomnia is difficulty with sleep onset, maintenance, early morning wakening or non-restorative sleep. Cancer prevalence is 30-75%. Daytime consequences include fatigue. It is under-reported and impairs quality of life. Measurement previously required sleep laboratories. Technology advances help real-time measurement in the natural environment. This study investigated the feasibility and acceptability of a wireless device to evaluate sleep in cancer.


METHODS
Prospective observational study: Stage A: 10 consecutive in-patient hospice admissions; Stage B: 20 consecutive community patients Sleep quality was rated by Insomnia Severity Index (ISI). Participants used a wireless non-contact bedside monitor (SleepMinder) for 3 nights. Acceptability questionnaires were completed by participant and nurse (Stage A) or family (Stage B).Descriptive statistics were generated by Microsoft Excel.


RESULTS
30 participants with metastatic cancer were recruited. Median age: 63 years (47-84). Median Eastern Cooperative Oncology Group (ECOG) performance score: 2 (0-3). In-patient (n=10): In 50%, sleep onset was delayed >30 minutes. Median duration: 8 hours. Median awakenings per night: 1 (0-8). Median sleep efficiency (proportion of time in bed spent asleep): 89% (74-100%). ISI score correlated with sleep duration in 70%. Participants and nurses reported 100% device acceptability. Community (n=20): Sleep onset was delayed >30 minutes in 25%. Median duration: 8 hours. Median awakenings per night: 3 (0-10). Median sleep efficiency: 91% (46-100). ISI score correlated with sleep duration in 90%. Participants and family reported 100% device acceptability.


CONCLUSIONS
(1)A wireless monitor effectively measures sleep in cancer in both inpatient and community settings, (2) High acceptability supports clinical use, (3) Subjective sleep quality reports correlate with device, and (4) Further research: evaluate sleep improvement interventions with device.