The clinical relevance of sleep disturbance (“insomnia”) in patients with advanced cancer receiving palliative care: a scoping review

Purpose Sleep disturbance (“insomnia”) is common in patients with advanced cancer receiving specialist palliative care. The aim of this scoping review was to determine the clinical relevance of sleep disturbance in this cohort of patients. Methods Standard methodology was employed, and four databases were searched from inception (Medline, CINAHL, Embase, and APA PsycInfo). Hand searching of relevant sources was also undertaken. Included studies needed to have a sleep focus, and to utilise a validated sleep assessment tool (and/or objective measure of sleep quality). Results Sixteen studies met the criteria for inclusion. The studies highlight that sleep disturbance is associated with a range of physical symptoms (e.g. fatigue, drowsiness), a variety of psychological problems (e.g. anxiety, depression), impaired quality of life, and reduced overall survival. Conclusion Sleep disturbance is an “orphan” symptom, and the results of this scoping review suggest that it deserves much greater attention. Indeed, healthcare professionals should screen all palliative care patients for the problem and, when identified, perform a thorough assessment and initiate an appropriate treatment.