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A screening method for sleep disturbances at the end-of-life

Published online by Cambridge University Press:  06 February 2020

Celia Ibáñez del Prado Open the ORCID record for Celia Ibáñez del Prado [Opens in a new window]  and
Juan Antonio Cruzado Open the ORCID record for Juan Antonio Cruzado [Opens in a new window]
Celia Ibáñez del Prado
Affiliation:
Hospital Virgen de la Poveda (SERMAS), Carretera del Hospital km. 5, Villa del Prado, Madrid28630, Spain
Juan Antonio Cruzado*
Affiliation:
Facultad Psicología Universidad Complutense de Madrid, Campus de Somosaguas, Ctra. de Húmera, s/n, Pozuelo de Alarcón, Madrid28223, Spain
*
Author for correspondence: Juan Antonio Cruzado, Facultad Psicología Universidad Complutense de Madrid, Campus de Somosaguas, Ctra. de Húmera, s/n, Pozuelo de Alarcón, Madrid28223, Spain. E-mail: jacruzad@ucm.es
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Abstract

Objective

To evaluate sleep disturbances and to verify the accuracy of three screening tests to detect them in patients at the end-of-life admitted in a hospital palliative care unit.

Method

The level of sleep disturbances was evaluated through the Pittsburgh Sleep Quality Index (PSQI) in 150 palliative patients. This questionnaire was the criterion variable for testing the three screening tests used: Edmonton Symptom Assessment System (ESAS-Sleep subscale); the single question “How much do you worry about your sleep problems?” which is answered on a scale of 0–10 (Sleep-Worry-Q) and another single question: “Do you think you have sleep problems?” with two response categories, Yes/No (Sleep-Problem-Q).

Results

According to the PSQI (cut-off point: 8), 87% of patients presented sleep disturbances. The ESAS-Sleep (cut-off point: 3) showed a sensitivity of 0.87, a specificity of 0.58, and an AUC of 0.729; the Sleep-Worry-Q (cut-off point: 4) showed a sensitivity of 0.95, a specificity of 0.68, and an AUC of 0.854; the Sleep-Problem-Q obtained a sensitivity of 0.92 and a specificity of 0.65.

Significance of results

Patients at the end-of-life, near the time of death, have high levels of sleep disturbances that can be detected early, with better diagnostic accuracy, with the Sleep-Worry-Q. Although from a clinical point of view, the application of the Sleep-Problem-Q may be more advantageous, as it presents good diagnostic accuracy, greater simplicity, and brevity.

Keywords

End-of-lifePalliative careScreening toolSleep disordersSleep disturbances
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Special Issue 4: Palliative and Supportive Care During The COVID-19 Pandemic , August 2020 , pp. 468 - 472
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Copyright
Copyright © Cambridge University Press 2020

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