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Table 4 Relationship between studied variables and insomnia according to the single question and the SDS (n = 61)

From: Insomnia among patients with advanced disease during admission in a Palliative Care Unit: a prospective observational study on its frequency and association with psychological, physical and environmental factors

 

Insomnia (single question)

Moderate-severe insomnia (SDS)

 

No or occasionally (n (%))

Yes (n (%))

p-value

No (n (%))

Yes (n (%))

p-value

Socio-demographic/clinical characteristics

 

Mean age ± SD, years

74.3 ± 9.73

69.8 ± 11.49

0.072

73.2 ± 9.95

69.6 ± 11.96

0.289

 

Sex

  

0.33

  

0.102

  

Women

12 (44.4)

15 (55.6)

 

11 (40.7)

16 (59.3)

 
  

Men

11 (32.4)

23 (67.6)

 

21 (61.8)

13 (38.2)

 
 

Karnofsky index

  

0.003 a

  

0.048

  

> 50

1 (6.3)

15 (93.8)

 

27 (60.0)

18 (40.0)

 
  

≤ 50

22 (48.9)

23 (51.1)

 

5 (31.3)

11 (68.8)

 
 

Procedence

  

0.11

  

0.060

  

Home

12 (50.0)

12 (50.0)

 

9 (37.5)

15 (62.5)

 
  

Acute care

11 (29.7)

26 (70.3)

 

23 (62.2)

14 (37.8)

 
 

Death during hospitalisation

  

0.768

  

0.088

  

No

13 (39.4)

20 (60.6)

 

18 (64.3)

10 (35.7)

 
  

Yes

10 (35.7)

18 (64.3)

 

14 (42.4)

19 (57.6)

 
 

Cancer site b

  

0.056

  

0.534

  

Lung

2 (15.4)

11 (84.6)

 

8 (61.5)

5 (38.5)

 
  

Other

21 (46.6)

24 (53.3)

 

22 (48.9)

23 (51.1)

 
  

Non-applicable

0 (0.0)

3 (100.0)

 

2 (66.7)

1 (33.3)

 
 

Stage b

  

0.239

  

0.888

  

Local or loco-regional disease

9 (56.3)

8 (43.8)

 

9 (56.2)

7 (43.5)

 
  

Metastasic

14 (33.3)

28 (66.7)

 

21 (50.0)

21 (50.0)

 
  

Non-applicable

0 (0.0)

3 (100.0)

 

2 (66.7)

1 (33.3)

 

Psychological factors

 

HADS (range 0-42) (mean ± SD)

18.2 ± 7.64

23.7 ± 6.98

0.012

20.3 ± 7.79

23.1 ± 7.44

0.158

 

HADS ≥ 19 c

  

0.137

  

0.806

  

No

11 (50.0)

11 (50.0)

 

12 (54.5)

10 (45.5)

 
  

Yes

12 (30.8)

27 (69.2)

 

20 (51.3)

19 (48.7)

 
 

HADD ≥ 11 d

  

0.204

  

0.306

  

No

11 (47.8)

12 (52.2)

 

14 (60.9)

9 (39.1)

 
  

Yes

12 (31.6)

26 (68.4)

 

18 (47.4)

20 (52.6)

 
 

HADA ≥ 11 e

  

0.019

  

0.234

  

No

15 (53.6)

13 (46.4)

 

17 (60.7)

11 (39.3)

 
  

Yes

8 (24.2)

25 (75.7)

 

15 (45.4)

18 (54.5)

 
 

Nightmares

  

0.535

  

0.163

  

No

18 (40.0)

27 (60.0)

 

26 (57.8)

19 (42.2)

 
  

Yes

5 (31.3)

11 (68.8)

 

6 (37.5)

10 (62.5)

 
 

Rumination

  

0.012 a

  

0.009 a

  

No

9 (69.2)

4 (30.8)

 

11 (86.4)

2 (15.4)

 
  

Yes

14 (29.2)

34 (70.8)

 

21 (43.8)

27 (56.3)

 
 

Feelings of fear/loneliness

  

0.222

  

0.055

  

No

14 (45.2)

17 (54.8)

 

20 (64.5)

11 (35.5)

 
  

Yes

9 (30.0)

21 (70.0)

 

12 (40.0)

18 (60.0)

 
 

Clear knowledge of diagnosis

  

0.042

  

0.065

  

No

12 (54.5)

10 (45.5)

 

17 (43.6)

22 (56.4)

 
  

Yes

11 (28.2)

28 (71.8)

 

15 (68.2)

7 (31.8)

 
 

Clear knowledge of prognosis

  

0.751

  

0.404

  

No

18 (36.7)

31 (63.3)

 

5 (41.7)

7 (58.3)

 
  

Yes

5 (41.7)

7 (58.3)

 

27 (55.1)

22 (44.9)

 

Physical factors f

 

Pain

  

0.633

  

0.986

  

No

8 (42.1)

11 (57.9)

 

10 (52.6)

9 (47.4)

 
  

Yes

15 (35.7)

27 (64.3)

 

22 (52.4)

20 (47.6)

 
 

Dyspnoea

  

0.018 a

  

0.436

  

No

19 (48.7)

20 (51.3)

 

19 (58.7)

20 (51.3)

 
  

Yes

4 (18.2)

18 (81.8)

 

13 (59.1)

9 (40.9)

 
 

Cough

  

0.649

  

0.381

  

No

17 (39.5)

26 (60.5)

 

21 (48.8)

22 (51.2)

 
  

Yes

6 (33.3)

12 (66.7)

 

11 (61.1)

7 (38.9)

 
 

Nausea/vomiting

  

0.150

  

0.501

  

No

15 (32.6)

31 (67.4)

 

23 (50.0)

23 (50.0)

 
  

Yes

8 (53.3)

7 (46.7)

 

9 (60.0)

6 (40.0)

 
 

Sweating

  

0.530

  

0.910

  

No

17 (35.4)

31 (64.6)

 

25 (52.1)

23 (47.9)

 
  

Yes

6 (46.2)

7 (53.8)

 

7 (53.8)

6 (46.2)

 
 

Nycturia

  

1.000

  

0.412

  

No

19 (38.0)

31 (62.0)

 

25 (50.0)

25 (50.0)

 
  

Yes

4 (36.0)

7 (63.6)

 

7 (63.6)

4 (36.4)

 

Environmental factors

 

Environmental disturbances

  

0.650

  

0.026

  

No

6 (42.9)

8 (57.1)

 

11 (78.6)

3 (21.4)

 
  

Yes

17 (36.2)

30 (63.8)

 

21 (44.7)

26 (55.3)

 
 

Individual room

  

0.301

  

0.754

  

No

18 (41.9)

25 (58.1)

 

22 (51.2)

21 (48.8)

 
  

Yes

5 (27.8)

13 (72.2)

 

10 (55.6)

8 (44.4)

 
 

Accompanied by next of kin during night

  

0.310

  

0.204

  

No

19 (41.3)

27 (58.7)

 

22 (47.8)

24 (52.2)

 
  

Yes

4 (26.7)

11 (73.3)

 

10 (66.7)

5 (33.3)

 
 

Sleeping habits not accomplished

  

0.217

  

0.276

  

No

18 (42.9)

24 (57.1)

 

24 (57.1)

18 (42.9)

 
  

Yes

5 (26.3)

14 (73.7)

 

8 (42.1)

11 (57.9)

 

Additional aspects related to insomnia

 

Daytime sleepiness

  

0.237

  

0.010 a

  

No

8 (50.0)

8 (50.0)

 

4 (25.0)

12 (75.0)

 
  

Yes

15 (33.3)

30 (66.7)

 

28 (62.2)

17 (37.8)

 
 

Feeling of non-restorative sleep

  

0.007

  

0.913

  

No

16 (55.2)

13 (44.8)

 

15 (51.7)

14 (48.3)

 
  

Yes

7 (21.9)

25 (78.1)

 

17 (53.1)

15 (46.9)

 
  1. aStatistical significance persisted after multivariate analysis.
  2. bStatistical analysis excluded the 3rd group (non-applicable).
  3. HADS: Hospital Anxiety and Depression Scale (higher scores indicate higher emotional distress).
  4. cIndicating clinically significant emotional distress.
  5. HADD: subscale Depression of HADS.
  6. dIndicating depressed mood.
  7. HADA: subscale Anxiety of HADS.
  8. eIndicating anxiety.
  9. fOnly those reported by > 8 patients presented.