Does Colorectal Cancer Site Influence Sleep Quality?

Abstract Introduction Understanding sleep quality among colorectal cancer (CRC) patients could contribute to improved survivorship care in terms of sleep recommendations. Methods We ascertained sleep quality within an ongoing population-based study of CRC patients identified through the Puget Sound SEER cancer registry. We assessed sleep quality using components of the standardized Pittsburg Sleep Quality Index. Differences in sleep quality by CRC site were analyzed using chi-square and ANOVA tests. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of tumor site (rectal vs. colon) with sleep quality concerns. ORs were adjusted for age at diagnosis, sex, BMI, education, cancer stage, and time since diagnosis. Results Of the 1,454 CRC patients included in analyses, 37% (N=543) had rectal cancer compared to 63% (N=911) with colon cancer, and the stage distribution was as follows: 37% localized, 43% regional, and 18% distant stage. Overall, participants with rectal (vs. colon) cancer were more likely to report problems related to trouble sleeping (OR [CI]: 1.63 [1.23, 2.16]), but were also less likely to report trouble sleeping specifically due to issues with breathing, coughing, or snoring (OR [CI]: 0.51 [0.27, 0.96]. However, rectal cancer patients were more likely than colon cancer patients to report changes in sleep patterns after cancer diagnosis (OR [CI]: 1.33 [1.02, 1.73]), and to report trouble sleeping specifically due to getting up to use the bathroom (OR [CI]: 1.49 [1.17, 1.90]) or pain (OR [CI]: 1.50 [1.10, 2.04]). There were no significant differences between rectal and colon cancer cases in terms of amount of sleep, problems staying awake, bad sleep quality, and use of sleep medication. Conclusion Overall, rectal cancer patients are more likely to have sleep complications due to potential physical consequences compared to colon cancer patients. This suggests that survivorship care may be adapted according to CRC site to ensure patients receive appropriate support in terms of sleep recommendation. Support (if any):