Uyku kalitesi ve geriatrik 8 (G8) skorunun multiple myelomlu yaşlı hastalarda kemoterapi ile değişimleri

Yıl 2021, Cilt: 46 Sayı: 4, 1574 - 1580, 30.12.2021

Mahmut Bakır Koyuncu Çağatay Çavuşoğlu Anıl Tombak Mehmet Ali Uçar Aydan Akdeniz Eyüp Naci Tiftik

Öz

Amaç: Bu çalışmada multipl miyelomlu yaşlı hastaların kemoterapi öncesi ve sonrası uyku kalitesini değerlendirmeyi ve uyku kalitesini etkileyen faktörleri araştırmayı amaçladık.
Gereç ve Yöntem: Yeni tanı konmuş Multipl miyelomlu toplam 108 hasta çalışmaya dahil edildi. Hastaların tanı anında Geriatrik 8 (G8) ve Pittsburgh Uyku Kalitesi İndeksi skorları hesaplandı ve bu skorlardaki değişiklikler üç kür kemoterapi sonrası değerlendirildi.
Bulgular: Hastaların 63'ünde (%58,3) tanı anında uyku bozukluğu vardı. Kemoterapiden sonra uyku bozukluğu oranının %41.7'ye düştüğü görüldü. Tedavi öncesi ve sonrası toplam G8 skorunda istatistiksel olarak anlamlı bir fark yoktu. Lojistik regresyon analizlerinde serum kalsiyum düzeyi, tedavi öncesi G8 skoru ve kemoterapiye yanıtın uyku kalitesinin belirleyicileri olduğu görüldü. Kemoterapiye iyi yanıt veren hastalarda uyku kalitesindeki artış anlamlı olarak daha yüksekti.
Sonuç: Uyku bozuklukları, multipl miyelomlu yaşlı hastalarda yaygın bir sorundur. Çalışmamız kemoterapi ile uyku kalitesinin arttığını ve uyku kalitesi düşük hastaların tedaviye yanıtlarının daha kötü olduğunu gösterdi. Bu nedenle bu hastaların uyku kalitesini artıracak önlemlere ve tedavilere ihtiyaç vardır.

Anahtar Kelimeler

multiple myelom, uyku kalitesi, geriatrik değerlendirme

Changes in sleep quality and geriatric-8 (G8) score with chemotherapy in older patients with multiple myeloma

Öz

Purpose: The aim of this study was to evaluate the sleep quality of older patients with multiple myeloma before and after chemotherapy and investigate factors affecting sleep quality.
Materials and Methods: A total of 108 patients with newly diagnosed multiple myeloma were included in the study. Geriatric 8 (G8) and Pittsburgh Sleep Quality Index scores were calculated for the patients at the time of diagnosis, and the changes in these scores were evaluated after three cycles of chemotherapy.
Results: At the time of diagnosis, 63 (58.3%) of the patients had sleep disturbances. The sleep disturbance rate decreased to 41.7% after chemotherapy. There was no statistically significant difference in the total G8 score before and after treatment. In logistic regression analyses, the serum calcium level, pre-treatment G8 score, and response to chemotherapy were predictors of sleep quality. Increases in sleep quality were significantly higher in patients with good responses to chemotherapy.
Conclusion: Sleep disturbances are a common problem in older patients with multiple myeloma. Our study demonstrated that sleep quality increased with chemotherapy, and patients with low sleep quality had worse responses to treatment. Therefore, there is a need for measures and treatments to increase the sleep quality of these patients.

Anahtar Kelimeler

Multiple myeloma, sleep quality, geriatric scores

Kaynakça

• 1. Welsh TJ, Gordon AL, Gladman JR. Comprehensive geriatric assessment--a guide for the non-specialist. Int J Clin Pract 2014;68:290-3.
• 2. Garcia MV, Agar MR, Soo WK, To T, Phillips JL. Screening Tools for Identifying Older Adults With Cancer Who May Benefit From a Geriatric Assessment: A Systematic Review. JAMA Oncol 2021;7:616-27.
• 3. Velghe A, Petrovic M, De Buyser S, Demuynck R, Noens L. Validation of the G8 screening tool in older patients with aggressive haematological malignancies. Eur J Oncol Nurs 2014;18:645-8.
• 4. Jakobsen G, Engstrøm M, Thronæs M, et al. Sleep quality in hospitalized patients with advanced cancer: an observational study using self-reports of sleep and actigraphy. Support Care Cancer 2020;28:2015-23.
• 5. Palesh OG, Roscoe JA, Mustian KM, et al. Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program. J Clin Oncol 2010;28:292-8.
• 6. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
• 7. Kim JH, Paik HJ, Jung YJ, et al. A Prospective Longitudinal Study about Change of Sleep, Anxiety, Depression, and Quality of Life in Each Step of Breast Cancer Patients. Oncology 2019;97:245-53.
• 8. Papadopoulos D, Kiagia M, Charpidou A, Gkiozos I, Syrigos K. Psychological correlates of sleep quality in lung cancer patients under chemotherapy: A single-center cross-sectional study. Psychooncology 2019;28:1879-86.
• 9. Zhang JX, Liu XH, Xie XH, et al. Mindfulness-based stress reduction for chronic insomnia in adults older than 75 years: a randomized, controlled, single-blind clinical trial. Explore (NY) 2015;11:180-5.
• 10. Zou Y, Chen Y, Yu W, et al. The prevalence and clinical risk factors of insomnia in the Chinese elderly based on comprehensive geriatric assessment in Chongqing population. Psychogeriatrics 2019;19:384-90.
• 11. Bellera CA, Rainfray M, Mathoulin-Pélissier S, et al. Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Ann Oncol 2012;23:2166-72.
• 12. Cavusoglu C, Deniz O, Tuna Dogrul R, et al. Validity and reliability of the G8 screening test in older non-cancer patients. Eur Geriatr Med 2021;12:397-404.
• 13. Simeit R, Deck R, Conta-Marx B. Sleep management training for cancer patients with insomnia. Support Care Cancer 2004;12:176-83.
• 14. Daniel LC, Aggarwal R, Schwartz LA. Sleep in Adolescents and Young Adults in the Year After Cancer Treatment. J Adolesc Young Adult Oncol 2017;6:560-7.
• 15. Vin-Raviv N, Akinyemiju TF, Galea S, Bovbjerg DH. Sleep disorder diagnoses and clinical outcomes among hospitalized breast cancer patients: a nationwide inpatient sample study. Support Care Cancer 2018;26:1833-40.
• 16. Rosen G, Harris AK, Liu M, Dreyfus J, Krueger J, Messinger YH. The effects of dexamethasone on sleep in young children with acute lymphoblastic leukemia. Sleep Med 2015;16:503-9.
• 17. Reid KJ, Baron KG, Lu B, Naylor E, Wolfe L, Zee PC. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Med 2010;11:934-40.
• 18. Wang WL, Chen KH, Pan YC, Yang SN, Chan YY. The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis. BMC Psychiatry 2020;20:195.
• 19. Vollbracht C, Schneider B, Leendert V, Weiss G, Auerbach L, Beuth J. Intravenous vitamin C administration improves quality of life in breast cancer patients during chemo-/radiotherapy and aftercare: results of a retrospective, multicentre, epidemiological cohort study in Germany. In Vivo 2011;25:983-90.
• 20. Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med 2021;17:263-98.
• 21. Zengin L, Aylaz R. The effects of sleep hygiene education and reflexology on sleep quality and fatigue in patients receiving chemotherapy. Eur J Cancer Care (Engl) 2019;28:e13020.