Sleep disorders in cancer survivors: A cross-sectional study from Morocco.

Abstract

e24133 Background: Sleep disturbances are among the most frequent and burdensome symptoms in patients with cancer and often persist into survivorship. The National Cancer Institute (NCI) defines a cancer survivor as any individual from the moment of diagnosis throughout the remainder of life, regardless of treatment status or time elapsed. Although the 5-year survival mark is commonly used as a symbolic threshold for long-term survival, many survivors continue to experience persistent physical and psychological sequelae that impair sleep. This study aimed to assess the prevalence and characteristics of sleep disorders among cancer survivors in a tertiary Moroccan oncology setting. Methods: We conducted a cross-sectional descriptive and analytical study over a 5-year period at Hassan II University Hospital, Fez, Morocco. Ethical approval and written informed consent were obtained. A subset of 63 cancer survivors was analyzed from a larger cohort of 323 oncology patients. Sleep disturbances were assessed using validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale. Results: The cohort had a mean age of 53.7 years (range 16–90), with 58.8% males. The most frequent cancers were colorectal (24.5%), prostate (24.1%), and gastric (22.6%). Most patients had metastatic disease (73.4%), and 63.2% were receiving chemotherapy. Sleep disturbances were highly prevalent: poor sleep quality (PSQI ≥5) in 96.0%, clinical insomnia (ISI >7) in 95.6%, and daytime sleepiness in 95.7%. Mean sleep duration was 4.79 hours, with a sleep latency of 1.7 hours. Sleep disorders were significantly associated with metastatic stage (p=0.013) and gastric cancer (p=0.046). Lifestyle factors showed no significant association. Only 11.5% of patients received hypnotic treatment. Conclusions: Sleep disturbances are extremely common among cancer survivors, particularly those with metastatic disease or receiving systemic therapy, and significantly impair quality of life. Disease- and treatment-related factors appear to outweigh lifestyle contributors. The marked gap between prevalence and management highlights the need for systematic screening and integration of evidence-based interventions, such as cognitive behavioral therapy for insomnia, into routine oncology care.