How does lymphoma affect the sleep quality and overall quality of life of long-term survivors?

This study analyzed the long-term effects of cancer on sleep quality and health-related quality of life (HRQOL) in 9-year NHL and HL survivors. The study concluded that poor sleep is associated with poor HRQOL.

Improvements in detecting and treating cancer have led to declining mortality rates. As the number of cancer survivors rises, achieving a high health-related quality of life (HRQOL) has become an important goal for patients. 

HRQOL includes factors that affect physical and mental health over the course of a disease, such as quality of sleep, insomnia, and fatigue. Hodgkin (HL) and non-Hodgkin (NHL) lymphoma survivors report greater fatigue and poorer overall HRQOL compared to the general population. Few studies looking at the sleep quality and HRQOL of these survivors exist compared to other cancer patient populations.

This study involved 515 survivors (398 NHL and 117 HL) with an average age of 63.1 years. Study participants self-reported their sleep quality, HRQOL, and likelihood of clinical depression in surveys.

51.8% of all participants were good sleepers. HL survivors (60.7%) reported better sleep quality than NHL survivors (49.0%). NHL and HL survivors had similar scores on the HRQOL survey. 54% of all participants reported feeling exhausted (lack of energy, tiredness, and inefficiency) after their cancer, with NHL survivors reporting more (56.5%) than HL survivors (45.2%). 11% of all participants showed a high chance of having clinical depression, with similar numbers between NHL (10.8%) and HL survivors (11.3%).

This study concluded that poor sleep is associated with poor HRQOL in NHL and HL survivors, and includes risk factors such as clinical depression, inability to work, and post-disease exhaustion.

This study was funded by Pfizer, though the authors report that the funders had no role in the study’s design, execution, or publication.

The current study included 54.7% of patients from the larger ELLY study; the sample size is large, but may exclude patients who feel too healthy to participate. Details such as treatment regimens and therapy locations were not included due to lack of information from the cancer registry. Beyond conditions such as diabetes, additional health conditions that could affect sleep quality such as chronic heart failure were also not included. Additional studies are needed to determine a clear causal link between poor sleep and poor HRQOL.

If you are 65 years or older and are a lymphoma survivor with difficulties sleeping, talk to your care team about incorporating exercise and other positive interventions to improve your quality of life.