Sleep quality in head and neck cancer patients

Angelina Maria Mirna Santoso

Research output: PhD ThesisPhD-Thesis - Research and graduation internal

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Abstract

Sleep quality is essential for optimal health and wellbeing of each individual. Previous research hypothesized that a good night’s sleep plays important role not only in energy conservation and emotional regulation, but also in maintaining diurnal rhythm of hypothalamic-pituitary-adrenal (HPA) axis. Sleep disturbances, together with physical and psychological distress, are known to disrupt HPA-axis activity, causing changes in normal fluctuation of cortisol level. This may further affect physiological functions of cortisol, among which the most important is regulation of inflammatory response. Despite extensive research on sleep quality in cancer patients in general, similar research in head and neck cancer (HNC) patients is scarce. HNC patients often suffer from psychological distress and physical symptoms starting from cancer diagnosis throughout treatment completion. These symptoms often compromise their quality of life and may play a role in their sleep quality. However, the prevalence of different kind of sleep disturbances in HNC patients throughout different treatment phases is unclear. We did not know which group of HNC patients already have poor sleep quality before the start of cancer treatment. We also did not know how sleep quality of HNC patients evolves overtime, and which HNC patients tend to have persistent poor sleep quality. Last but not least, there is lack of research which highlights the complex relationship between sleep quality, pain, fatigue, psychological distress, HPA-axis, and inflammation in newly diagnosed HNC patients. This thesis aims to address these research gaps by investigating the epidemiology, trajectories, and associated factors of poor sleep quality in newly diagnosed HNC patients, taking into account personal, physical, psychological, and biological parameters. Findings in this thesis suggest that screening for poor sleep quality in HNC patients should be started shortly after HNC diagnosis. Moreover, it is important to first clearly define the type of sleep disturbance of interest and then choose a validated sleep screening instrument accordingly. A periodic sleep evaluation should be aimed to HNC patients who are more at risk of having persistent poor sleep quality. This group of patients may benefit from early intervention which simultaneously targets poor sleep quality and other (psychoneurological) symptoms. These findings also provide directions for future research, for example into the long-term effects of poor sleep quality, disruptions of HPA-axis and inflammatory dysregulations on HNC progression and survival.
Original languageEnglish
QualificationPhD
Awarding Institution
  • Vrije Universiteit Amsterdam
Supervisors/Advisors
  • Verdonck-de Leeuw, Irma, Supervisor
  • van Straten, Annemieke, Supervisor
  • Jansen, Femke, Co-supervisor, -
Award date29 Jun 2023
Print ISBNs9789464693621
DOIs
Publication statusPublished - 29 Jun 2023

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