Associations between Sleep Disorders and Comfort at End-of-Life: Opportunities for Improvement

Abstract

Comfort and quality of life (QoL) at the end-of-life (EOL) comprise physical and psychosocial domains. The effects of sleep disorders such as insomnia on comfort-related factors have been widely reported for cancer patients, yet the effect of sleep disorders on comfort may be less well-documented for non-cancer conditions. Quantifying these effects may inform improvements in EOL comfort by treating sleep disorders. The objective of this literature review is to quantify associations between sleep disorders and comfort in non-cancer patients at EOL. A systematic review of the literature identified three articles comprising a total of 239 participants, 88% males, 83% with cancer. Comfort-related factors included QoL, dyspnea, rumination, depression, delirium, anxiety, cognitive impairment, and suicidal ideation. The effect of sleep disorders on comfort related factors was substantial. There is a gap in the literature indicating a need for future studies in this area.

Keywords

• Sleep wake disorders
• Palliative care
• Terminal care
• Patient comfort