Zaburzenia snu – Rokowania, prognozy i postęp choroby

Zaburzenia snu
Rokowania, prognozy i postęp choroby

Prognozowanie wyników leczenia zaburzeń snu, zwłaszcza bezsenności, wymaga uwzględnienia wielu czynników prognostycznych, takich jak przestrzeganie zaleceń terapeutycznych (OR = 3,07; 95% CI: 1,28-7,34), wyjściowe nasilenie bezsenności (OR = 1,15; 95% CI: 1,01-1,30 po terapii oraz OR = 1,14; 95% CI: 1,01-1,29 w obserwacji 6-miesięcznej) oraz dysfunkcyjne przekonania dotyczące snu (OR = 1,02; 95% CI: 1,00-1,05). Terapia poznawczo-behawioralna bezsenności (CBT-I) wykazuje wyższą skuteczność w porównaniu z terapią akceptacji i zaangażowania (ACT-I), szczególnie w ramach wczesnych, spersonalizowanych interwencji i programów telemedycznych. W przypadku obturacyjnego bezdechu sennego (OSA), regularne stosowanie CPAP poprawia objawy w krótkim terminie (4-8 tygodni), jednak długoterminowe efekty, zwłaszcza w kontekście zapobiegania powikłaniom sercowo-naczyniowym, pozostają niepotwierdzone w badaniach randomizowanych. Ciężki nieleczony OSA (AHI ≥ 30) wiąże się ze zwiększonym ryzykiem śmiertelności sercowo-naczyniowej, natomiast leczenie CPAP może łagodzić to ryzyko.

Prognozy dla zaburzeń snu

Czynniki wpływające na rokowanie w zaburzeniach snu
Prognozy dla różnych form terapii
Prognozy dla obturacyjnego bezdechu sennego

Prognostyczne znaczenie zaburzeń snu w innych schorzeniach

Zaburzenia snu u pacjentów onkologicznych
Zaburzenia snu w depresji
Zaburzenia snu a zdrowie psychiczne

Znaczenie badań przesiewowych i wczesnej identyfikacji
Przyszłe kierunki badań i poprawa prognozowania

Kolejne rozdziały

Prognozy dla zaburzeń snu

Przewidywanie wyników leczenia zaburzeń snu, szczególnie bezsenności, stanowi istotne wyzwanie dla współczesnej medycyny. Skuteczność różnych form terapii może znacząco różnić się w zależności od indywidualnych cech pacjenta, co podkreśla potrzebę opracowania wiarygodnych modeli prognostycznych.¹² Modele predykcyjne mogą być pomocnym narzędziem wspierającym klinicystów w wyborze optymalnej strategii leczenia, jednak obecnie brak jest zewnętrznie zwalidowanych modeli, co stanowi istotną lukę w literaturze naukowej.³

Czynniki wpływające na rokowanie w zaburzeniach snu

Skuteczne leczenie zaburzeń snu zależy od wielu czynników, które mogą wpływać na rokowanie. Badania wskazują na następujące istotne elementy prognostyczne:⁴

Przestrzeganie zaleceń terapeutycznych – wyższy poziom przestrzegania zaleceń zwiększa szanse na pozytywną odpowiedź na leczenie (iloraz szans OR = 3,07; 95% CI: 1,28-7,34)⁵
Wyjściowe nasilenie bezsenności – każdy dodatkowy punkt w wyjściowym nasileniu bezsenności zwiększa szansę na odpowiedź na leczenie zarówno po zakończeniu terapii (OR = 1,15; 95% CI: 1,01-1,30), jak i w obserwacji 6-miesięcznej (OR = 1,14; 95% CI: 1,01-1,29)⁶
Dysfunkcyjne przekonania na temat snu – każdy dodatkowy punkt w skali przekonań dotyczących snu zwiększa szanse na odpowiedź na leczenie (OR = 1,02; 95% CI: 1,00-1,05)⁷

Prognozy dla różnych form terapii

Porównując różne metody terapeutyczne w leczeniu bezsenności, badania wskazują, że terapia poznawczo-behawioralna bezsenności (CBT-I) zwiększa szansę na odpowiedź na leczenie w porównaniu z terapią akceptacji i zaangażowania dla bezsenności (ACT-I).⁸ Terapie niefarmakologiczne są szczególnie skuteczne we wczesnych interwencjach, zwłaszcza przy zastosowaniu spersonalizowanych ścieżek leczenia i programów telemedycznych.⁹

Prognozy dla obturacyjnego bezdechu sennego

W przypadku obturacyjnego bezdechu sennego (OSA), krótkoterminowe rokowanie w odniesieniu do objawów, takich jak senność w ciągu dnia i chrapanie, waha się od dobrego do doskonałego przy regularnym stosowaniu terapii CPAP (ciągłe dodatnie ciśnienie w drogach oddechowych).¹⁰ Badania wykazały znaczącą poprawę w zakresie funkcji poznawczych i ogólnego stanu zdrowia po 4-8 tygodniach leczenia CPAP, jednak brakuje badań przeprowadzonych na dużej populacji lub przez dłuższy okres.¹¹

Długoterminowe rokowanie pozostaje nieznane ze względu na brak randomizowanych badań oceniających wpływ CPAP na zapobieganie rozwojowi powikłań sercowo-naczyniowych.¹² Badania obserwacyjne wskazują jednak, że ciężki nieleczony OSA (wskaźnik AHI ≥ 30) wiąże się ze zwiększonym ryzykiem śmiertelności sercowo-naczyniowej, definiowanej jako zawał mięśnia sercowego lub udar zakończone zgonem.¹³

Pacjenci z łagodnym OSA lub poddawani leczeniu CPAP nie wykazywali znacząco zwiększonego ilorazu szans w porównaniu z grupą osób bez OSA.¹⁴ Kilka badań wskazuje, że CPAP łagodzi zwiększoną śmiertelność obserwowaną w OSA, co sugeruje, że OSA jest niezależnym czynnikiem ryzyka rozwoju chorób sercowo-naczyniowych i zgonu.¹⁵

Prognostyczne znaczenie zaburzeń snu w innych schorzeniach

Zaburzenia snu u pacjentów onkologicznych

Wysoka częstość występowania bezsenności u pacjentów onkologicznych prowadzi do znacznego obniżenia jakości życia osób dotkniętych tym problemem.¹⁶ Literatura konsekwentnie wykazuje silny związek między zaburzeniami snu a chorobą nowotworową różnych typów.¹⁷ Wczesne wykrywanie parametrów związanych ze snem odgrywa kluczową rolę u pacjentów onkologicznych, umożliwiając identyfikację i leczenie modyfikowalnych czynników tak szybko, jak to możliwe.¹⁸¹⁹

Implementacja ścisłego procesu przesiewowego może potencjalnie zmniejszyć ryzyko niedodiagnozowania bezsenności w codziennej praktyce klinicznej.²⁰ Korzystne byłoby, gdyby lekarze wdrożyli wytyczne praktyki klinicznej ESMO, które zalecają badanie przesiewowe pacjentów w kierunku bezsenności.²¹

Zaburzenia snu w depresji

Bezsenność i obiektywnie mierzone zaburzenia snu są czynnikami prognostycznymi dla słabej odpowiedzi na leczenie u pacjentów z dużym zaburzeniem depresyjnym (MDD).²² Przedłużona latencja snu, występująca samodzielnie (OR = 3,53; 95% CI: 1,28-9,73) lub w połączeniu z bezsennością (OR = 2,11; 95% CI: 1,13-3,95), przewiduje zwiększone ryzyko braku remisji.²³ Badania sugerują, że obiektywnie mierzona przedłużona latencja snu i krótki czas snu, niezależnie lub w połączeniu z bezsennością, są czynnikami ryzyka niekorzystnego wyniku leczenia depresji.²⁴

Zaburzenia snu a zdrowie psychiczne

Badania wykazują, że satysfakcja z życia jest negatywnie związana z problemami zdrowia psychicznego, a zaburzenia snu mogą pośredniczyć w tym związku.²⁵ Satysfakcja z życia ma negatywny wpływ na problemy zdrowia psychicznego, a związek między satysfakcją z życia a problemami zdrowia psychicznego jest częściowo zapośredniczony przez zaburzenia snu.²⁶²⁷

Na podstawie analiz mediacji moderowanej stwierdzono, że powierzchnia mieszkalna na osobę (PCBA) może moderować bezpośredni wpływ satysfakcji z życia na problemy zdrowia psychicznego oraz drugą połowę pośredniego efektu od zaburzeń snu do problemów zdrowia psychicznego.²⁸ Bezpośredni wpływ satysfakcji z życia na problemy zdrowia psychicznego i wpływ zaburzeń snu na problemy zdrowia psychicznego były silniejsze przy niskim poziomie PCBA.²⁹

Znaczenie badań przesiewowych i wczesnej identyfikacji

Wczesna identyfikacja zaburzeń snu jest kluczowa dla poprawy rokowania. Implementacja badań przesiewowych w rutynowej opiece klinicznej może pomóc w identyfikacji pacjentów z zaburzeniami snu, co umożliwia wczesną interwencję.³⁰ Jednak istnieją przesłanki wskazujące, że te praktyki przesiewowe nie są powszechnie stosowane w praktyce klinicznej.³¹

Wczesne wykrywanie pozostaje niezbędne w celu identyfikacji modyfikowalnych czynników tak szybko, jak to możliwe, co pozwala zaoferować pacjentom odpowiednie opcje leczenia.³² Dokładne podejście do wykrywania bezsenności pozostaje konieczne, aby móc oceniać i leczyć pacjentów zgodnie z ich potrzebami.³³

Przyszłe kierunki badań i poprawa prognozowania

Wyniki badań podkreślają potrzebę opracowania i walidacji nowoczesnych, metodologicznie rygorystycznych modeli predykcyjnych dla odpowiedzi na leczenie bezsenności.³⁴³⁵ Przyszłe badania koncentrujące się na opracowywaniu i walidacji takich modeli mogą umożliwić klinicystom dostosowanie strategii leczenia do unikalnych potrzeb każdego pacjenta, potencjalnie prowadząc do lepszych wyników i poprawy jakości życia osób cierpiących na bezsenność.³⁶

Dokładne modele predykcyjne dla wyników leczenia bezsenności mogą mieć znaczące korzyści kliniczne, w tym poprawę opieki nad pacjentem, zmniejszenie kosztów opieki zdrowotnej związanych z bezsennością oraz minimalizację ryzyka zdarzeń niepożądanych związanych z niewłaściwym wyborem leczenia.³⁷

Wieloośrodkowe badanie wykorzystujące wszystkie instrumenty przesiewowe i systematycznie testujące różnice grupowe, szczególnie że wyniki ogólnie między narzędziami oceny bezsenności wykazują niespójność i różnice płciowe, byłoby krokiem opartym na dowodach w kierunku ustalenia wspólnie uzgodnionych standardów systematycznej oceny bezsenności u pacjentów onkologicznych.³⁸

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Materiały źródłowe

#1 Prognostic models for predicting insomnia treatment outcomes: A systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC11687218/
To identify and critically evaluate models predicting insomnia treatment response in adult populations. […] Prediction models may be a useful tool to assist clinicians in selecting the optimal treatment strategy for patients with insomnia. However, no externally validated models currently exist. These results highlight an important gap in the literature and underscore the need for the development and validation of modern, methodologically rigorous models. […] Given that insomnia treatment response varies widely depending on the individual, prediction models may be a promising tool to help clinicians identify which treatments are most likely to benefit a particular patient. […] Accurate prediction models for insomnia treatment outcomes could have significant clinical benefits, including improved patient care, reduced insomnia-related healthcare costs, and minimizing the risk of adverse events associated with inappropriate treatment selection.
#2 Prognostic models for predicting insomnia treatment outcomes: A systematic review – PubMed
https://pubmed.ncbi.nlm.nih.gov/38141325/
Objective: To identify and critically evaluate models predicting insomnia treatment response in adult populations. […] Prediction models may be a useful tool to assist clinicians in selecting the optimal treatment strategy for patients with insomnia. However, no externally validated models currently exist. These results highlight an important gap in the literature and underscore the need for the development and validation of modern, methodologically rigorous models.
#3 Prognostic models for predicting insomnia treatment outcomes: A systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC11687218/
While there are a variety of insomnia treatments available, their effectiveness can vary substantially depending on the individual patient. Prediction models may be a useful tool to assist clinicians in selecting the optimal treatment strategy for patients with insomnia, however, external validation studies are needed to determine the utility and generalizability of the currently published models. […] These results highlight an important gap in the literature and underscore the need for modern, methodologically rigorous models. Future research efforts focused on developing and validating such models could enable clinicians to tailor treatment strategies to the unique needs of each patient, potentially leading to better outcomes and improved quality of life for individuals suffering from insomnia.
#4 Adherence, Insomnia Severity, and Sleep Beliefs Predict Treatment Response to CBT-I or ACT-I – Neurology Advisor
https://www.neurologyadvisor.com/news/factors-in-treatment-response-for-insomnia/
Cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments. […] The researchers also found that adherence increased the odds of post-treatment response (OR, 3.07; 95%, 1.28-7.34). […] Further, each additional point in baseline insomnia severity (OR, 1.15; 95%, 1.01-1.30) and dysfunctional sleep belief scores (OR, 1.02; 95%, 1.00-1.05) raises the odds of post-treatment response. […] Each additional point in baseline insomnia severity also had increased odds in treatment response at 6-month follow-up (OR, 1.14; 95%, 1.01-1.29). […] In conclusion, cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia, the study authors concluded. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments.
#5 Adherence, Insomnia Severity, and Sleep Beliefs Predict Treatment Response to CBT-I or ACT-I – Neurology Advisor
https://www.neurologyadvisor.com/news/factors-in-treatment-response-for-insomnia/
Cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments. […] The researchers also found that adherence increased the odds of post-treatment response (OR, 3.07; 95%, 1.28-7.34). […] Further, each additional point in baseline insomnia severity (OR, 1.15; 95%, 1.01-1.30) and dysfunctional sleep belief scores (OR, 1.02; 95%, 1.00-1.05) raises the odds of post-treatment response. […] Each additional point in baseline insomnia severity also had increased odds in treatment response at 6-month follow-up (OR, 1.14; 95%, 1.01-1.29). […] In conclusion, cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia, the study authors concluded. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments.
#6 Adherence, Insomnia Severity, and Sleep Beliefs Predict Treatment Response to CBT-I or ACT-I – Neurology Advisor
https://www.neurologyadvisor.com/news/factors-in-treatment-response-for-insomnia/
Cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments. […] The researchers also found that adherence increased the odds of post-treatment response (OR, 3.07; 95%, 1.28-7.34). […] Further, each additional point in baseline insomnia severity (OR, 1.15; 95%, 1.01-1.30) and dysfunctional sleep belief scores (OR, 1.02; 95%, 1.00-1.05) raises the odds of post-treatment response. […] Each additional point in baseline insomnia severity also had increased odds in treatment response at 6-month follow-up (OR, 1.14; 95%, 1.01-1.29). […] In conclusion, cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia, the study authors concluded. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments.
#7 Adherence, Insomnia Severity, and Sleep Beliefs Predict Treatment Response to CBT-I or ACT-I – Neurology Advisor
https://www.neurologyadvisor.com/news/factors-in-treatment-response-for-insomnia/
Cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments. […] The researchers also found that adherence increased the odds of post-treatment response (OR, 3.07; 95%, 1.28-7.34). […] Further, each additional point in baseline insomnia severity (OR, 1.15; 95%, 1.01-1.30) and dysfunctional sleep belief scores (OR, 1.02; 95%, 1.00-1.05) raises the odds of post-treatment response. […] Each additional point in baseline insomnia severity also had increased odds in treatment response at 6-month follow-up (OR, 1.14; 95%, 1.01-1.29). […] In conclusion, cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia, the study authors concluded. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments.
#8 Adherence, Insomnia Severity, and Sleep Beliefs Predict Treatment Response to CBT-I or ACT-I – Neurology Advisor
https://www.neurologyadvisor.com/news/factors-in-treatment-response-for-insomnia/
Cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments. […] The researchers also found that adherence increased the odds of post-treatment response (OR, 3.07; 95%, 1.28-7.34). […] Further, each additional point in baseline insomnia severity (OR, 1.15; 95%, 1.01-1.30) and dysfunctional sleep belief scores (OR, 1.02; 95%, 1.00-1.05) raises the odds of post-treatment response. […] Each additional point in baseline insomnia severity also had increased odds in treatment response at 6-month follow-up (OR, 1.14; 95%, 1.01-1.29). […] In conclusion, cognitive behavioural therapy for insomnia increases the chance of treatment response compared with acceptance and commitment therapy for insomnia, the study authors concluded. […] Moreover, higher adherence, insomnia severity and dysfunctional beliefs about sleep predict treatment outcome in both treatments.
#9 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
However, there are references to the fact that these screening practices are not widely used in clinical practice. […] But early detection remains necessary in order to identify modifiable factors as early as possible, which then allows offering patients appropriate treatment options. […] A systematic literature review by Bttner-Teleag et al. points to the effectiveness of alternative non-drug treatments of cancer patients with insomnia; especially early interventions with personalized pathways and web-based telehealth programs. […] The implementation of a close-meshed screening process could potentially reduce the risk of underdiagnosis of insomnia in everyday clinical practice. […] A finely differentiated approach to the detection of insomnia therefore remains necessary in order to be able to assess and treat patients according to their needs.
#10 Obstructive Sleep Apnea (OSA): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/295807-overview
The short-term prognosis, in relation to symptoms such as daytime sleepiness and snoring, ranges from good to excellent with regular use of CPAP. Several studies, including placebo-controlled studies, have shown significant improvement in measures of cognitive function and general health status (eg, as measured by the Medical Outcome Study Short-Form 36 health survey) after 4-8 weeks of treatment with CPAP. However, studies have not been performed in a large population or for more than a 4- to 8-week treatment period. […] The long-term prognosis is unknown because no randomized treatment studies investigating the effect of CPAP on preventing the development of cardiovascular sequelae have been conducted. […] The effect of OSA on mortality has been investigated using observational cohort studies. Marin et al found in a Spanish cohort that severe untreated OSA (AHI 30) is associated with an increased risk of cardiovascular mortality, defined by fatal myocardial infarction (MI) or stroke.
#11 Obstructive Sleep Apnea (OSA): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/295807-overview
The short-term prognosis, in relation to symptoms such as daytime sleepiness and snoring, ranges from good to excellent with regular use of CPAP. Several studies, including placebo-controlled studies, have shown significant improvement in measures of cognitive function and general health status (eg, as measured by the Medical Outcome Study Short-Form 36 health survey) after 4-8 weeks of treatment with CPAP. However, studies have not been performed in a large population or for more than a 4- to 8-week treatment period. […] The long-term prognosis is unknown because no randomized treatment studies investigating the effect of CPAP on preventing the development of cardiovascular sequelae have been conducted. […] The effect of OSA on mortality has been investigated using observational cohort studies. Marin et al found in a Spanish cohort that severe untreated OSA (AHI 30) is associated with an increased risk of cardiovascular mortality, defined by fatal myocardial infarction (MI) or stroke.
#12 Obstructive Sleep Apnea (OSA): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/295807-overview
The short-term prognosis, in relation to symptoms such as daytime sleepiness and snoring, ranges from good to excellent with regular use of CPAP. Several studies, including placebo-controlled studies, have shown significant improvement in measures of cognitive function and general health status (eg, as measured by the Medical Outcome Study Short-Form 36 health survey) after 4-8 weeks of treatment with CPAP. However, studies have not been performed in a large population or for more than a 4- to 8-week treatment period. […] The long-term prognosis is unknown because no randomized treatment studies investigating the effect of CPAP on preventing the development of cardiovascular sequelae have been conducted. […] The effect of OSA on mortality has been investigated using observational cohort studies. Marin et al found in a Spanish cohort that severe untreated OSA (AHI 30) is associated with an increased risk of cardiovascular mortality, defined by fatal myocardial infarction (MI) or stroke.
#13 Obstructive Sleep Apnea (OSA): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/295807-overview
The short-term prognosis, in relation to symptoms such as daytime sleepiness and snoring, ranges from good to excellent with regular use of CPAP. Several studies, including placebo-controlled studies, have shown significant improvement in measures of cognitive function and general health status (eg, as measured by the Medical Outcome Study Short-Form 36 health survey) after 4-8 weeks of treatment with CPAP. However, studies have not been performed in a large population or for more than a 4- to 8-week treatment period. […] The long-term prognosis is unknown because no randomized treatment studies investigating the effect of CPAP on preventing the development of cardiovascular sequelae have been conducted. […] The effect of OSA on mortality has been investigated using observational cohort studies. Marin et al found in a Spanish cohort that severe untreated OSA (AHI 30) is associated with an increased risk of cardiovascular mortality, defined by fatal myocardial infarction (MI) or stroke.
#14 Obstructive Sleep Apnea (OSA): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/295807-overview
Patients with mild OSA or those undergoing treatment with CPAP did not have a significantly increased odds ratio compared with a group of subjects without OSA. […] In this study, the authors also found that untreated severe OSA is a significant risk factor for the development of cardiovascular morbidity, which included nonfatal MI and stroke. […] Several other studies indicate that CPAP mitigates the increased mortality observed in OSA. […] All of the above evidence strongly suggests that OSA is an independent risk factor for the development of cardiovascular disease and death. However, at this time, no definitive randomized studies have investigated the effect of CPAP in preventing the potential cardiovascular risks.
#15 Obstructive Sleep Apnea (OSA): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/295807-overview
Patients with mild OSA or those undergoing treatment with CPAP did not have a significantly increased odds ratio compared with a group of subjects without OSA. […] In this study, the authors also found that untreated severe OSA is a significant risk factor for the development of cardiovascular morbidity, which included nonfatal MI and stroke. […] Several other studies indicate that CPAP mitigates the increased mortality observed in OSA. […] All of the above evidence strongly suggests that OSA is an independent risk factor for the development of cardiovascular disease and death. However, at this time, no definitive randomized studies have investigated the effect of CPAP in preventing the potential cardiovascular risks.
#16 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
The high prevalence of insomnia in cancer patients leads to a significant reduction in the quality of life of those affected. […] Our findings indicate a closer correlation between the screening question pertaining to sleep disorders and the ISI, compared to the question on tiredness and the ISI. […] The initial recording of sleep-related parameters plays an essential role for cancer patients in order to identify and treat modifiable factors as promptly as possible. […] The literature consistently shows evidence of a strong association between sleep disorders and cancer disease of various entities. […] Sleep disorders and the resulting daytime tiredness lead to a severely impaired quality of life for patients. […] This evidence highlights the importance of a screening procedure implemented in the clinical care routine to identify cancer patients with sleep disorders.
#17 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
The high prevalence of insomnia in cancer patients leads to a significant reduction in the quality of life of those affected. […] Our findings indicate a closer correlation between the screening question pertaining to sleep disorders and the ISI, compared to the question on tiredness and the ISI. […] The initial recording of sleep-related parameters plays an essential role for cancer patients in order to identify and treat modifiable factors as promptly as possible. […] The literature consistently shows evidence of a strong association between sleep disorders and cancer disease of various entities. […] Sleep disorders and the resulting daytime tiredness lead to a severely impaired quality of life for patients. […] This evidence highlights the importance of a screening procedure implemented in the clinical care routine to identify cancer patients with sleep disorders.
#18 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
The high prevalence of insomnia in cancer patients leads to a significant reduction in the quality of life of those affected. […] Our findings indicate a closer correlation between the screening question pertaining to sleep disorders and the ISI, compared to the question on tiredness and the ISI. […] The initial recording of sleep-related parameters plays an essential role for cancer patients in order to identify and treat modifiable factors as promptly as possible. […] The literature consistently shows evidence of a strong association between sleep disorders and cancer disease of various entities. […] Sleep disorders and the resulting daytime tiredness lead to a severely impaired quality of life for patients. […] This evidence highlights the importance of a screening procedure implemented in the clinical care routine to identify cancer patients with sleep disorders.
#19 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
However, there are references to the fact that these screening practices are not widely used in clinical practice. […] But early detection remains necessary in order to identify modifiable factors as early as possible, which then allows offering patients appropriate treatment options. […] A systematic literature review by Bttner-Teleag et al. points to the effectiveness of alternative non-drug treatments of cancer patients with insomnia; especially early interventions with personalized pathways and web-based telehealth programs. […] The implementation of a close-meshed screening process could potentially reduce the risk of underdiagnosis of insomnia in everyday clinical practice. […] A finely differentiated approach to the detection of insomnia therefore remains necessary in order to be able to assess and treat patients according to their needs.
#20 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
However, there are references to the fact that these screening practices are not widely used in clinical practice. […] But early detection remains necessary in order to identify modifiable factors as early as possible, which then allows offering patients appropriate treatment options. […] A systematic literature review by Bttner-Teleag et al. points to the effectiveness of alternative non-drug treatments of cancer patients with insomnia; especially early interventions with personalized pathways and web-based telehealth programs. […] The implementation of a close-meshed screening process could potentially reduce the risk of underdiagnosis of insomnia in everyday clinical practice. […] A finely differentiated approach to the detection of insomnia therefore remains necessary in order to be able to assess and treat patients according to their needs.
#21 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
It would be beneficial for physicians to implement the ESMO Clinical Practice Guidelines, which recommends screening patients for insomnia. […] The frequency analysis of the response behavior to the sleep disorder question and the tiredness question identified 20 patients (30%) with moderate to severe tiredness without relevant insomnia or sleep problems. […] This shows that tiredness in cancer patients can be caused by numerous factors: cancer-related anemia, psychological depression, cachexia, a loss of appetite, stressful medication (chemotherapeutic agents), obstructive sleep apnea syndrome (OSA), and listlessness are just a handful of these factors. […] A multi-center study using all screening instruments and systematically testing group differences, especially as our results generally between insomnia assessment tools show incongruence and gender differences, would be an evidence-based step towards setting jointly agreed standards for the systematic assessment of insomnia in cancer patients.
#22 Insomnia and Objectively Measured Sleep Disturbances Predict Treatment Outcome in Depressed Patients Treated With Psychotherapy or Psychotherapy-Pharmacotherapy Combinations
https://www.psychiatrist.com/jcp/insomnia-objectively-measured-sleep-disturbances-predict/
Insomnia and objectively measured sleep disturbances predict poor treatment outcomes in patients with major depressive disorder (MDD). […] Prolonged sleep latency alone (OR = 3.53; 95% CI, 1.28-9.73) or in combination with insomnia (OR = 2.11; 95% CI, 1.13-3.95) predicted increased risk of nonremission. […] Findings suggest that objectively measured prolonged sleep latency and short sleep duration independently or in conjunction with insomnia are risk factors for poor depression treatment outcome.
#23 Insomnia and Objectively Measured Sleep Disturbances Predict Treatment Outcome in Depressed Patients Treated With Psychotherapy or Psychotherapy-Pharmacotherapy Combinations
https://www.psychiatrist.com/jcp/insomnia-objectively-measured-sleep-disturbances-predict/
Insomnia and objectively measured sleep disturbances predict poor treatment outcomes in patients with major depressive disorder (MDD). […] Prolonged sleep latency alone (OR = 3.53; 95% CI, 1.28-9.73) or in combination with insomnia (OR = 2.11; 95% CI, 1.13-3.95) predicted increased risk of nonremission. […] Findings suggest that objectively measured prolonged sleep latency and short sleep duration independently or in conjunction with insomnia are risk factors for poor depression treatment outcome.
#24 Insomnia and Objectively Measured Sleep Disturbances Predict Treatment Outcome in Depressed Patients Treated With Psychotherapy or Psychotherapy-Pharmacotherapy Combinations
https://www.psychiatrist.com/jcp/insomnia-objectively-measured-sleep-disturbances-predict/
Insomnia and objectively measured sleep disturbances predict poor treatment outcomes in patients with major depressive disorder (MDD). […] Prolonged sleep latency alone (OR = 3.53; 95% CI, 1.28-9.73) or in combination with insomnia (OR = 2.11; 95% CI, 1.13-3.95) predicted increased risk of nonremission. […] Findings suggest that objectively measured prolonged sleep latency and short sleep duration independently or in conjunction with insomnia are risk factors for poor depression treatment outcome.
#25 Association between life satisfaction, sleep disturbance and mental health problems among the migrant older adults with children: a conditional process analysis based on per capita bedroom area | BMC Geriatrics | Full Text
https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-025-05957-y
Life satisfaction was negatively associated with mental health problems, and sleep disturbance could mediate their association. […] Furthermore, the direct effect of life satisfaction on mental health problems and the indirect effect of sleep disturbance in the relationship were moderated by PCBA, but it only moderated the direct effect and the second indirect link (sleep disturbance-mental health problems) of the mediating effect. […] Life satisfaction had negative effect on mental health problems. PCBA moderated the direct effect of life satisfaction on mental health problems and the mediating effect of sleep disturbance on mental health problems. […] This study illustrated that the association between life satisfaction and mental health problems was partially mediated by sleep disturbance.
#26 Association between life satisfaction, sleep disturbance and mental health problems among the migrant older adults with children: a conditional process analysis based on per capita bedroom area | BMC Geriatrics | Full Text
https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-025-05957-y
Life satisfaction was negatively associated with mental health problems, and sleep disturbance could mediate their association. […] Furthermore, the direct effect of life satisfaction on mental health problems and the indirect effect of sleep disturbance in the relationship were moderated by PCBA, but it only moderated the direct effect and the second indirect link (sleep disturbance-mental health problems) of the mediating effect. […] Life satisfaction had negative effect on mental health problems. PCBA moderated the direct effect of life satisfaction on mental health problems and the mediating effect of sleep disturbance on mental health problems. […] This study illustrated that the association between life satisfaction and mental health problems was partially mediated by sleep disturbance.
#27 Association between life satisfaction, sleep disturbance and mental health problems among the migrant older adults with children: a conditional process analysis based on per capita bedroom area | BMC Geriatrics | Full Text
https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-025-05957-y
Based on the moderated mediation analyses, PCBA was found could moderate the direct effect of life satisfaction on mental health problems and the second half of the indirect effect from sleep disturbance to mental health problems. […] The direct effect of life satisfaction on mental health problems and the effect of sleep disturbance on mental health problems were stronger at the low level of PCBA. […] This study found the life satisfaction was negatively associated with the mental health problems, which confirmed the Hypothesis 1 and was consistent with the previous studies. […] This study illustrated that the association between life satisfaction and mental health problems was partially mediated by sleep disturbance, which confirmed the Hypothesis 2 and also explained how life satisfaction could indirectly affect mental health problems. […] PCBA moderated the indirect link (sleep disturbance-mental health problems) of life satisfaction on mental health problems mediated by sleep disturbance.
#28 Association between life satisfaction, sleep disturbance and mental health problems among the migrant older adults with children: a conditional process analysis based on per capita bedroom area | BMC Geriatrics | Full Text
https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-025-05957-y
Based on the moderated mediation analyses, PCBA was found could moderate the direct effect of life satisfaction on mental health problems and the second half of the indirect effect from sleep disturbance to mental health problems. […] The direct effect of life satisfaction on mental health problems and the effect of sleep disturbance on mental health problems were stronger at the low level of PCBA. […] This study found the life satisfaction was negatively associated with the mental health problems, which confirmed the Hypothesis 1 and was consistent with the previous studies. […] This study illustrated that the association between life satisfaction and mental health problems was partially mediated by sleep disturbance, which confirmed the Hypothesis 2 and also explained how life satisfaction could indirectly affect mental health problems. […] PCBA moderated the indirect link (sleep disturbance-mental health problems) of life satisfaction on mental health problems mediated by sleep disturbance.
#29 Association between life satisfaction, sleep disturbance and mental health problems among the migrant older adults with children: a conditional process analysis based on per capita bedroom area | BMC Geriatrics | Full Text
https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-025-05957-y
Based on the moderated mediation analyses, PCBA was found could moderate the direct effect of life satisfaction on mental health problems and the second half of the indirect effect from sleep disturbance to mental health problems. […] The direct effect of life satisfaction on mental health problems and the effect of sleep disturbance on mental health problems were stronger at the low level of PCBA. […] This study found the life satisfaction was negatively associated with the mental health problems, which confirmed the Hypothesis 1 and was consistent with the previous studies. […] This study illustrated that the association between life satisfaction and mental health problems was partially mediated by sleep disturbance, which confirmed the Hypothesis 2 and also explained how life satisfaction could indirectly affect mental health problems. […] PCBA moderated the indirect link (sleep disturbance-mental health problems) of life satisfaction on mental health problems mediated by sleep disturbance.
#30 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
The high prevalence of insomnia in cancer patients leads to a significant reduction in the quality of life of those affected. […] Our findings indicate a closer correlation between the screening question pertaining to sleep disorders and the ISI, compared to the question on tiredness and the ISI. […] The initial recording of sleep-related parameters plays an essential role for cancer patients in order to identify and treat modifiable factors as promptly as possible. […] The literature consistently shows evidence of a strong association between sleep disorders and cancer disease of various entities. […] Sleep disorders and the resulting daytime tiredness lead to a severely impaired quality of life for patients. […] This evidence highlights the importance of a screening procedure implemented in the clinical care routine to identify cancer patients with sleep disorders.
#31 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
However, there are references to the fact that these screening practices are not widely used in clinical practice. […] But early detection remains necessary in order to identify modifiable factors as early as possible, which then allows offering patients appropriate treatment options. […] A systematic literature review by Bttner-Teleag et al. points to the effectiveness of alternative non-drug treatments of cancer patients with insomnia; especially early interventions with personalized pathways and web-based telehealth programs. […] The implementation of a close-meshed screening process could potentially reduce the risk of underdiagnosis of insomnia in everyday clinical practice. […] A finely differentiated approach to the detection of insomnia therefore remains necessary in order to be able to assess and treat patients according to their needs.
#32 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
However, there are references to the fact that these screening practices are not widely used in clinical practice. […] But early detection remains necessary in order to identify modifiable factors as early as possible, which then allows offering patients appropriate treatment options. […] A systematic literature review by Bttner-Teleag et al. points to the effectiveness of alternative non-drug treatments of cancer patients with insomnia; especially early interventions with personalized pathways and web-based telehealth programs. […] The implementation of a close-meshed screening process could potentially reduce the risk of underdiagnosis of insomnia in everyday clinical practice. […] A finely differentiated approach to the detection of insomnia therefore remains necessary in order to be able to assess and treat patients according to their needs.
#33 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
However, there are references to the fact that these screening practices are not widely used in clinical practice. […] But early detection remains necessary in order to identify modifiable factors as early as possible, which then allows offering patients appropriate treatment options. […] A systematic literature review by Bttner-Teleag et al. points to the effectiveness of alternative non-drug treatments of cancer patients with insomnia; especially early interventions with personalized pathways and web-based telehealth programs. […] The implementation of a close-meshed screening process could potentially reduce the risk of underdiagnosis of insomnia in everyday clinical practice. […] A finely differentiated approach to the detection of insomnia therefore remains necessary in order to be able to assess and treat patients according to their needs.
#34 Prognostic models for predicting insomnia treatment outcomes: A systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC11687218/
While there are a variety of insomnia treatments available, their effectiveness can vary substantially depending on the individual patient. Prediction models may be a useful tool to assist clinicians in selecting the optimal treatment strategy for patients with insomnia, however, external validation studies are needed to determine the utility and generalizability of the currently published models. […] These results highlight an important gap in the literature and underscore the need for modern, methodologically rigorous models. Future research efforts focused on developing and validating such models could enable clinicians to tailor treatment strategies to the unique needs of each patient, potentially leading to better outcomes and improved quality of life for individuals suffering from insomnia.
#35 Prognostic models for predicting insomnia treatment outcomes: A systematic review – PubMed
https://pubmed.ncbi.nlm.nih.gov/38141325/
Objective: To identify and critically evaluate models predicting insomnia treatment response in adult populations. […] Prediction models may be a useful tool to assist clinicians in selecting the optimal treatment strategy for patients with insomnia. However, no externally validated models currently exist. These results highlight an important gap in the literature and underscore the need for the development and validation of modern, methodologically rigorous models.
#36 Prognostic models for predicting insomnia treatment outcomes: A systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC11687218/
While there are a variety of insomnia treatments available, their effectiveness can vary substantially depending on the individual patient. Prediction models may be a useful tool to assist clinicians in selecting the optimal treatment strategy for patients with insomnia, however, external validation studies are needed to determine the utility and generalizability of the currently published models. […] These results highlight an important gap in the literature and underscore the need for modern, methodologically rigorous models. Future research efforts focused on developing and validating such models could enable clinicians to tailor treatment strategies to the unique needs of each patient, potentially leading to better outcomes and improved quality of life for individuals suffering from insomnia.
#37 Prognostic models for predicting insomnia treatment outcomes: A systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC11687218/
To identify and critically evaluate models predicting insomnia treatment response in adult populations. […] Prediction models may be a useful tool to assist clinicians in selecting the optimal treatment strategy for patients with insomnia. However, no externally validated models currently exist. These results highlight an important gap in the literature and underscore the need for the development and validation of modern, methodologically rigorous models. […] Given that insomnia treatment response varies widely depending on the individual, prediction models may be a promising tool to help clinicians identify which treatments are most likely to benefit a particular patient. […] Accurate prediction models for insomnia treatment outcomes could have significant clinical benefits, including improved patient care, reduced insomnia-related healthcare costs, and minimizing the risk of adverse events associated with inappropriate treatment selection.
#38 Investigation of screening questions to identify insomnia in cancer patients | Scientific Reports
https://www.nature.com/articles/s41598-024-69086-z
It would be beneficial for physicians to implement the ESMO Clinical Practice Guidelines, which recommends screening patients for insomnia. […] The frequency analysis of the response behavior to the sleep disorder question and the tiredness question identified 20 patients (30%) with moderate to severe tiredness without relevant insomnia or sleep problems. […] This shows that tiredness in cancer patients can be caused by numerous factors: cancer-related anemia, psychological depression, cachexia, a loss of appetite, stressful medication (chemotherapeutic agents), obstructive sleep apnea syndrome (OSA), and listlessness are just a handful of these factors. […] A multi-center study using all screening instruments and systematically testing group differences, especially as our results generally between insomnia assessment tools show incongruence and gender differences, would be an evidence-based step towards setting jointly agreed standards for the systematic assessment of insomnia in cancer patients.