Abstract 3226: Sleep disruption among prostate cancer survivors by metastatic disease status
Authors: Shreves Alaina H. , Mucci Lorelei , Valdimarsdottir Unnur , Markt Sarah , Penney Kathryn 
Published: June 2022

Abstract
Introduction: Advances in cancer screening, diagnosis, and treatment have resulted in an increasing population of cancer survivors, many of whom experience persistent cancer-related side effects. Multiple studies have found that cancer survivors report poorer sleep than the general population. More than 3 million men in the US are prostate cancer survivors, yet few existing studies have focused on sleep in this population, especially among men with metastatic disease. Thus, a better understanding of sleep problems among prostate cancer survivors could help characterize how sleep affects the quality of life among men with prostate cancer.
Aim: To describe sleep behaviors and problems among prostate cancer survivors overall and specifically among those with metastatic disease.
Methods: Self-reported sleep data, including sleep disruption, sleep apnea, and insomnia, were obtained from the 2018 Prostate Cancer Follow-up Survey (PCFS) administered to participants of the Health Professionals Follow-Up Study with a diagnosis of prostate cancer. We evaluated each item individually and calculated a score for clinical insomnia using the validated Women’s Health Initiative Insomnia Rating Scale (range 1-20; score &gt;10 indicative of clinically relevant insomnia). Descriptive analyses on sleep measures were conducted overall and stratified by metastatic disease. We utilized multivariable linear regression models to compare metastatic disease status and insomnia score, adjusting for age, race, body mass index, physical activity, smoking, and other health information.
Results: Of 2,431 men (median age: 83 years) who completed the 2018 survey, 87 had metastatic disease, de novo or men who progressed after diagnosis. Sleep disturbances were relatively common in this population. Among all men with prostate cancer, 33% (n=290) reported waking up several times a night five or more times a week, 14% (n=337) rated their sleep quality as restless, and 15% (n=368) reported a clinical diagnosis with sleep apnea. The Insomnia Rating Scale scores were relatively high among all prostate cancer survivors with a mean score of 9.0 (95% CI 6.0-12.0). Scores significantly differed by metastatic disease status and men with metastatic disease had scores that were 1.30 (95% CI 0.19-2.41) points higher than men without metastatic disease.
Conclusion: The growing global number of prostate cancer survivors with metastatic disease and the potentially high prevalence of negative cancer-related quality of life effects pose pressing challenges to health systems. Our findings suggest that sleep disturbances are common among prostate cancer survivors. Men with metastatic disease had poorer sleep overall and higher rates of clinical insomnia than men without metastatic disease. These results could highlight the importance of sleep among men with prostate cancer and could increase the clinical treatment of sleep problems.
Citation Format: Alaina H. Shreves, Lorelei Mucci, Unnur Valdimarsdottir, Sarah Markt, Kathryn Penney. Sleep disruption among prostate cancer survivors by metastatic disease status [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3226.