{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:21:15Z","timestamp":1777922475649,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Palliat Care"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    Difficulty sleeping is common in palliative care, however often unrecognized by palliative care physicians. This retrospective review aims to gain a better understanding of the causes and treatment of sleeping disturbances in a tertiary palliative care unit.\n                    <jats:bold>Methods:<\/jats:bold>\n                    This study included 200 palliative care inpatients admitted between January 1, 2015, and August 31, 2020. Patients with sleep disturbances were placed into 3 subgroups: insomnia, delirium, and those with an unclear diagnosis. These categories were analyzed by bivariate analysis (ANOVA, Kruskal-Wallis) to determine statistical significance.\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 156 (78%) patients had symptoms suggestive of sleep disturbance and 163 (81.5%) patients were prescribed a sedative for sleep disturbance. Most patients were prescribed lorazepam (52 [26%]), followed by haloperidol (47 [23.5%]), and zopiclone (33 [16.5%]). Benzodiazepine and zopiclone prescribing decreased over time, while antipsychotic prescribing remained stable. When analyzed according to the most likely cause of the sleep disturbance, patients with insomnia had a higher Palliative Performance Score (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.035) and were more likely to have a previous medical history of insomnia (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.0003) than those with delirium. Both insomnia and delirium were quickly diagnosed but patients with unclear sleep disturbances took longer to recognize and treat.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    These results suggest that sleep disturbances are common at the end of life and can be challenging to categorize. Using specific criteria may be helpful in differentiating insomnia versus delirium and ultimately lead to more consistent approaches to management.\n                  <\/jats:p>","DOI":"10.1177\/08258597241309723","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T19:37:39Z","timestamp":1736969859000},"page":"351-357","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterizing Difficulties and Management of Sleep Disturbances in a Tertiary Palliative Care Unit\u2014A Retrospective Review"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6483-8078","authenticated-orcid":false,"given":"Jennifer","family":"Schacter","sequence":"first","affiliation":[{"name":"Palliative Care Program, Winnipeg Regional Health Authority, Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Pilkey","sequence":"additional","affiliation":[{"name":"Departments of Internal Medicine and Family Medicine, Section of Palliative Care Medicine, University of Manitoba, Winnipeg, Canada"},{"name":"Palliative Care Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780199656097.001.0001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60750-2"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000071"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-015-0550-8"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216319854944"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0244"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120907021"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40675-020-00174-y"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201500380"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.13448"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15292"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.2739"},{"issue":"4","key":"e_1_3_2_14_2","first-page":"26","article-title":"The palliative performance scale version 2 (PPSv2)","volume":"9","author":"Victoria Hospice Society","year":"2001","unstructured":"Victoria Hospice Society. The palliative performance scale version 2 (PPSv2). J Pall Care. 2001;9(4):26-32.","journal-title":"J Pall Care"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.09.010"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.14521"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.06.018"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-016-3524-4"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27286"},{"issue":"40","key":"e_1_3_2_20_2","first-page":"1","article-title":"Insomnia among patients with advanced disease during admission in a palliative care unit: A prospective observational study on its frequency and association with psychological, physical and environmental factors","volume":"13","author":"Reno-Guiteras A","year":"2014","unstructured":"Reno-Guiteras A, Planas J, Farriols C, et al. Insomnia among patients with advanced disease during admission in a palliative care unit: A prospective observational study on its frequency and association with psychological, physical and environmental factors. BMC Palliat Care. 2014;13(40):1-12.","journal-title":"BMC Palliat Care."},{"key":"e_1_3_2_21_2","first-page":"1","article-title":"Benzodiazepines and related drugs for insomnia in palliative care (review)","volume":"4","author":"Hirst A","year":"2010","unstructured":"Hirst A, Sloan R. Benzodiazepines and related drugs for insomnia in palliative care (review). Cochrane Database Syst Rev. 2010;4:1-20.","journal-title":"Cochrane Database Syst Rev."},{"issue":"2","key":"e_1_3_2_22_2","first-page":"225","article-title":"Meta-analysis of benzodiazepine use in the treatment of insomnia","volume":"162","author":"Holbrook AM","year":"2000","unstructured":"Holbrook AM, Crowther R, Lotter A, Cheng C, King D. Meta-analysis of benzodiazepine use in the treatment of insomnia. 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Standard of Practice Prescribing Benzodiazepine and Z-Drugs (including Zopiclone & other drugs). 2020."},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951505050042"}],"container-title":["Journal of Palliative Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08258597241309723","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08258597241309723","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08258597241309723","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:21:33Z","timestamp":1777666893000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08258597241309723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/08258597241309723"],"URL":"https:\/\/doi.org\/10.1177\/08258597241309723","relation":{},"ISSN":["0825-8597","2369-5293"],"issn-type":[{"value":"0825-8597","type":"print"},{"value":"2369-5293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,15]]}}}