Colorectal Cancer Anatomical Site and Sleep Quality

SIMPLE SUMMARY: Around 70% of colorectal cancer patients report having sleeping issues, and identifying whether anatomic site plays a significant factor in sleep quality is important. The aim of our population-based study was to assess differences in sleep between rectal and colon cancer patients. We identified that rectal cancer patients were more likely to have sleep complications, such as changes in sleep patterns after diagnosis, getting up to use the bathroom, and pain, compared to colon cancer patients. Identifying whether anatomic colorectal cancer site affects sleep quality and sleep-related issues suggests that sleep-focused survivorship care may be suggested for rectal cancer patients to ensure patients receive appropriate support. ABSTRACT: Purpose: Sleep quality in relation to anatomic site among colorectal cancer (CRC) patients is not well understood, though discerning the relationship could contribute to improved survivorship care. Methods: We ascertained sleep quality (Pittsburgh Sleep Quality Index) and other personal characteristics within an ongoing population-based study of CRC patients identified through a cancer registry (N = 1453). 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 with sleep quality concerns, adjusting for patient attributes and time since diagnosis. Results: Sleeping problems were reported by 70% of CRC patients. Overall, participants with rectal (vs. colon) cancer were more likely (OR (95% CI)) to report general trouble sleeping (1.58 (1.19, 2.10)). Rectal cancer patients were also more likely than colon cancer patients to report changes in sleep patterns after cancer diagnosis (1.38 (1.05, 1.80)), and trouble sleeping specifically due to getting up to use the bathroom (1.53 (1.20, 1.96)) or pain (1.58 (1.15, 2.17)), but were less likely to report trouble sleeping specifically due to issues with breathing/coughing/snoring (0.51 (0.27, 0.99)). Conclusion: Overall, rectal cancer patients were more likely to have sleep complications compared to colon cancer patients. This suggests sleep-focused survivorship care may be adapted according to CRC site to ensure patients receive appropriate support.