BMJ supportive & palliative care · 2026
Association between insomnia and prognosis in patients with cancer: a prospective cohort study.
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Ben Kridis Wala, Dhouibi Loay, Khanfir Afef
Аннотация
OBJECTIVES: This study aims to assess the prevalence of insomnia in patients with cancer and evaluate its association with overall survival, considering related symptoms such as anxiety and pain.
METHODS: A prospective cohort study was conducted at Habib Bourguiba University Hospital in Sfax, Tunisia, involving adult patients with cancer. Data were collected through validated sleep assessment tools (Insomnia Symptom Questionnaire and Insomnia Severity Index). The impact of insomnia, alongside associated symptoms, on survival was assessed using Kaplan-Meier analysis and Cox regression.
RESULTS: Among 100 patients, 78% reported insomnia, with pain and anxiety being the most common triggers. Insomnia was significantly associated with poorer overall survival (p<0.0001). Multivariate analysis revealed insomnia (HR=2.85, p=0.02) and metastatic disease (HR=3.21, p=0.01) as independent predictors of reduced survival.
CONCLUSIONS: Insomnia, along with related symptoms like anxiety and pain, is highly prevalent among patients with cancer and significantly associated with worse survival outcomes. This highlights the need for systematic screening and management of sleep disturbances, as well as a broader focus on symptom clusters in oncology care.
METHODS: A prospective cohort study was conducted at Habib Bourguiba University Hospital in Sfax, Tunisia, involving adult patients with cancer. Data were collected through validated sleep assessment tools (Insomnia Symptom Questionnaire and Insomnia Severity Index). The impact of insomnia, alongside associated symptoms, on survival was assessed using Kaplan-Meier analysis and Cox regression.
RESULTS: Among 100 patients, 78% reported insomnia, with pain and anxiety being the most common triggers. Insomnia was significantly associated with poorer overall survival (p<0.0001). Multivariate analysis revealed insomnia (HR=2.85, p=0.02) and metastatic disease (HR=3.21, p=0.01) as independent predictors of reduced survival.
CONCLUSIONS: Insomnia, along with related symptoms like anxiety and pain, is highly prevalent among patients with cancer and significantly associated with worse survival outcomes. This highlights the need for systematic screening and management of sleep disturbances, as well as a broader focus on symptom clusters in oncology care.