世界睡眠医学杂志2026，Vol.13Issue(2)：253-256,4.DOI:10.3969/j.issn.2095-7130.2026.02.007
食管癌患者放疗联合免疫治疗期间睡眠障碍的临床特征及影响因素分析
Clinical Characteristics and Influencing Factors of Sleep Disorders in Patients with Esophageal Cancer During Radiotherapy Combined with Immunotherapy
摘要
Abstract
Objective:To investigate the incidence,clinical characteristics,and related influencing factors of sleep disorders in patients with esophageal cancer during radiotherapy combined with immunotherapy.Methods:A prospective study was conducted on 75 patients with esophageal cancer who received radiotherapy combined with immunotherapy at the Affiliated Cancer Hospital of Nantong University/Nantong Tumor Hospital from January 2022 to December 2024.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate their sleep status from the fourth week of treatment,with a total PSQI score＞7 defined as the presence of sleep disorders.The incidence of sleep disorders in patients was analyzed.Based on the occurrence of sleep disorders,the patients were divided into an observation group(n=48)and a control group(n=27)to evaluate the clinical characteristics and influen-cing factors of sleep disorders.Results:Among the 75 patients,48 experienced sleep disorders,with an incidence rate of 64.00％(48/75).An analysis of the 48 patients with sleep disorders revealed that the incidence of difficulty initiating sleep,frequent noc-turnal awakenings,and early morning awakening all exceeded 70％.The total sleep time,sleep efficiency,N2 phase sleep propor-tion,N3 phase sleep proportion,and rapid eye movement(REM)sleep proportion of patients in the observation group were signifi-cantly lower than those in the control group.The sleep latency,wake after sleep onset(WASO),and N1 phase sleep proportion were significantly higher than those in the control group,and the differences were statistically significant(P＜0.05).The occur-rence of sleep disorders was significantly correlated with age,educational level,clinical stage,radiation esophagitis,fatigue,pain,anxiety state,and depression state(P＜0.05).Moderate-to-severe fatigue,anxiety,and depression were independent risk factors for patients to develop sleep disorders(P＜0.05).Conclusion:The incidence of sleep disorders in esophageal cancer patients during radiotherapy combined with immunotherapy is as high as 64.00％,and there are significant changes in sleep status and sleep proportion,which are mainly closely related to fatigue,anxiety,and depression.Clinical screening and intervention should be given priority.关键词
食管肿瘤/放射治疗/免疫治疗/睡眠障碍/匹兹堡睡眠质量指数/影响因素Key words
Esophageal cancer/Radiotherapy/Immunotherapy/Sleep disorders/Pittsburgh Sleep Quality Index/Influencing factors分类
医药卫生引用本文复制引用
张紫寒,沈健,杨百霞..食管癌患者放疗联合免疫治疗期间睡眠障碍的临床特征及影响因素分析[J].世界睡眠医学杂志,2026,13(2):253-256,4.基金项目
南通市卫生健康委员会科研课题(MS2023059). （MS2023059）
