{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:59:44Z","timestamp":1792789184533,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sanofi","id":[{"id":"https:\/\/ror.org\/02n6c9837","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Up to 95% of cancer patients report sleep disturbances or disorders. These can potentially influence cancer development and outcomes. This study aimed to review the existing literature to understand the patient experience of cancer-related sleep impairment across indications and treatments, to improve awareness and inform disease treatment\/management. Methods: A targeted literature review of published qualitative studies exploring sleep impairment in oncology was conducted in MEDLINE, Embase, and PsycINFO. Concepts were extracted from the reviewed articles, and patient quotes or author descriptions\/interpretations were subject to secondary analysis using semantic, qualitative, directed content analysis techniques via ATLAS.ti. Results informed the development of a patient-centric conceptual model. Results: From 482 identified publications, 22 publications were selected for in-depth review and concept extraction, collectively including 531 patients across 25 different oncology indications. Cancer-related sleep impairment frequently affected patients living with cancer, who reported difficulty obtaining good quality sleep, including difficulty falling asleep and staying asleep. Sleep problems were triggered by the emotional anxiety of life with cancer, cancer-related symptoms, treatments and side effects, and external factors. Poor sleep greatly impacted daily life for patients, with difficulties in daily life causing further sleep impairment, in a cyclical relationship. Conclusions: This study determined that there is an unmet need for treatment of sleep impairment in oncology to improve patient outcomes. The holistic conceptual model developed in this study can provide an important basis for selecting, developing, or modifying outcome measures to assess relevant sleep outcomes, facilitating discussion between patients and clinicians and improving disease treatment\/management.<\/jats:p>","DOI":"10.3390\/cancers18193191","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:50:38Z","timestamp":1790959838000},"page":"3191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sleep Impairment in Oncology: Development of a Novel Patient-Centric Conceptual Model"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-2205","authenticated-orcid":false,"given":"Harriet","family":"Makin","sequence":"first","affiliation":[{"name":"Clinical Outcomes Assessment, Clarivate Analytics, 70. St Mary Axe, London EC3A 8BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4737-0987","authenticated-orcid":false,"given":"Sophie","family":"Van Tomme","sequence":"additional","affiliation":[{"name":"Patient-Driven Medicines Development, Sanofi, Paasheuvelweg 25, 1105BP Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6573-7431","authenticated-orcid":false,"given":"Natalie V. J.","family":"Aldhouse","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Assessment, Clarivate Analytics, 70. St Mary Axe, London EC3A 8BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0552-181X","authenticated-orcid":false,"given":"Samantha","family":"Wratten","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Assessment, Clarivate Analytics, 70. St Mary Axe, London EC3A 8BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5519-0794","authenticated-orcid":false,"given":"Helen","family":"Kitchen","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Assessment, Clarivate Analytics, 70. St Mary Axe, London EC3A 8BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2278-2176","authenticated-orcid":false,"given":"Chloe","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Assessment, Clarivate Analytics, 70. St Mary Axe, London EC3A 8BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8820-8822","authenticated-orcid":false,"given":"Cecile","family":"Gousset","sequence":"additional","affiliation":[{"name":"Patient-Driven Medicines Development, Sanofi, 82 Avenue Raspail, 94255 Gentilly, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Cordero","sequence":"additional","affiliation":[{"name":"Patient-Driven Medicines Development, Sanofi, 410 Thames Valley Park Dr, Earley, Reading RG6 1PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"B\u00fcttner-Teleag\u0103, A., Kim, Y.T., Osel, T., and Richter, K. (2021). Sleep Disorders in Cancer-A Systematic Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182111696"},{"key":"ref_2","unstructured":"National Cancer Institute (2023, December 19). Sleep Problems in People with Cancer, Available online: https:\/\/www.cancer.gov\/about-cancer\/treatment\/side-effects\/sleep-problems."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Lanza, G., Mogavero, M.P., Salemi, M., and Ferri, R. (2024). The Triad of Sleep, Immunity, and Cancer: A Mediating Perspective. Cells, 13.","DOI":"10.3390\/cells13151246"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"101409","DOI":"10.1016\/j.smrv.2020.101409","article-title":"Sleep disorders and cancer: State of the art and future perspectives","volume":"56","author":"Mogavero","year":"2021","journal-title":"Sleep Med. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.sleep.2016.06.041","article-title":"Sleep duration is associated with survival in advanced cancer patients","volume":"32","author":"Collins","year":"2017","journal-title":"Sleep Med."},{"key":"ref_6","unstructured":"Food and Drug Administration (FDA) (2022). Patient-Focused Drug Development: Selecting, Developing, or Modifying Fit-for-Purpose Clinical Outcome Assessments, Guidance for Industry (DRAFT), Food and Drug Administration Staff, and Other Stakeholders."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.drudis.2021.12.003","article-title":"The overlooked vital sign: The importance of measuring sleep in drug development studies","volume":"27","author":"McCarthy","year":"2022","journal-title":"Drug Discov. Today"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1007\/s11764-023-01330-3","article-title":"A qualitative study of sleep in young breast cancer survivors: \u201cNo longer able to sleep through the night\u201d","volume":"18","author":"Hwang","year":"2023","journal-title":"J. Cancer Surviv."},{"key":"ref_9","unstructured":"(2023, June 01). Critical Appraisal Skills Programme. CASP Qualitative Checklist. Available online: https:\/\/casp-uk.net\/casp-tools-checklists\/qualitative-studies-checklist\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1093\/abm\/kaac035","article-title":"\u201cI Beat Cancer to Feel Sick:\u201d Qualitative Experiences of Sleep Disturbance in Black Breast Cancer Survivors and Recommendations for Culturally Targeted Sleep Interventions","volume":"56","author":"Geiss","year":"2022","journal-title":"Ann. Behav. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/nop\/npaa081","article-title":"Understanding sleep disturbance in the context of malignant brain tumors: A qualitative analysis","volume":"8","author":"Jeon","year":"2021","journal-title":"Neuro-Oncol. Pract."},{"key":"ref_12","first-page":"3865","article-title":"Barriers to managing sleep disturbance in people with malignant brain tumours and their caregivers: A qualitative analysis of healthcare professionals\u2019 perception","volume":"29","author":"Jeon","year":"2021","journal-title":"Support. Care Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s40271-019-00393-8","article-title":"\u201cLower abdominal pains, as if I was being squeezed...in a clamp\u201d: A Qualitative Analysis of Symptoms, Patient-Perceived Side Effects and Impacts of Ovarian Cancer","volume":"13","author":"Martin","year":"2020","journal-title":"Patient"},{"key":"ref_14","first-page":"5859","article-title":"Patient perspectives on symptoms, health-related quality of life, and treatment experience associated with relapsed\/refractory multiple myeloma","volume":"30","author":"Nathwani","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"van Eck, I., den Hollander, D., Lidington, E., Hentschel, L., Eichler, M., Salah, S., Singer, S., Pinto, M., Fauske, L., and Fiore, M. (2021). Health-Related Quality of Life Issues Experienced by Thoracic and Breast Sarcoma Patients: A Rare and Understudied Group. J. Clin. Med., 10.","DOI":"10.3390\/jcm10225334"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","year":"2005","journal-title":"Qual. Health Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Lincoln, Y.S., and Guba, E.G. (1985). Naturalistic Inquiry, Sage.","DOI":"10.1016\/0147-1767(85)90062-8"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S423","DOI":"10.1016\/j.jval.2023.09.2212","article-title":"MSR154 Qualitative Content Analysis for Concept Elicitation (CACE) in Clinical Outcome Assessment Development","volume":"26","author":"Carmichael","year":"2023","journal-title":"Value Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.3390\/curroncol30010097","article-title":"The Experience of Mindfulness-Based Stress Reduction on Menopausal Symptoms, Sleep Disturbance, and Body Image among Patients with Breast Cancer-A Qualitative Study","volume":"30","author":"Chang","year":"2023","journal-title":"Curr. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1017\/S1478951518000135","article-title":"A qualitative examination of the factors related to the development and maintenance of insomnia in cancer survivors","volume":"17","author":"Garland","year":"2019","journal-title":"Palliat. Support. Care"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ibrar, M., Peddie, N., Agnew, S., Diserholt, A., and Fleming, L. (2022). Breast Cancer Survivors\u2019 Lived Experience of Adjuvant Hormone Therapy: A Thematic Analysis of Medication Side Effects and Their Impact on Adherence. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.861198"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/bjhp.12446","article-title":"Living with persistent insomnia after cancer: A qualitative analysis of impact and management","volume":"26","author":"Fleming","year":"2021","journal-title":"Br. J. Health Psychol."},{"key":"ref_23","first-page":"6689","article-title":"Barriers and facilitators to implementing a stepped care cognitive-behavioral therapy for insomnia in cancer patients: A qualitative study","volume":"30","author":"Savard","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1080\/07347332.2021.1910396","article-title":"Cancer patient\u2019s attitudes of using medicinal cannabis for sleep","volume":"40","author":"Zhou","year":"2022","journal-title":"J. Psychosoc. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1002\/cam4.4955","article-title":"Conceptual assessment of HRQOL among Japanese non-metastatic castration-resistant prostate cancer (nmCRPC) patients","volume":"12","author":"Nishimura","year":"2023","journal-title":"Cancer Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"101397","DOI":"10.1016\/j.jgo.2022.10.012","article-title":"Symptom experiences of older adults during treatment for metastatic prostate cancer: A qualitative investigation","volume":"14","author":"Parthipan","year":"2023","journal-title":"J. Geriatr. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1007\/s11764-022-01279-9","article-title":"Development of a disease conceptual model of patient experience with metastatic colorectal cancer: Identification of the most salient symptoms and impacts","volume":"18","author":"Guillemin","year":"2022","journal-title":"J. Cancer Surviv."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/bjd.19298","article-title":"Current measures are not sufficient: An interview-based qualitative assessment of quality of life in cutaneous T-cell lymphoma","volume":"184","author":"Bhat","year":"2021","journal-title":"Br. J. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s40487-021-00174-0","article-title":"Patient Perspectives on Health-Related Quality of Life in Diffuse Large B-Cell Lymphoma Treated with Car T-Cell Therapy: A Qualitative Study","volume":"10","author":"Cheng","year":"2022","journal-title":"Oncol. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s40487-021-00166-0","article-title":"Understanding the Patient Experience in NUT Carcinoma: Qualitative Interviews with Patients and Caregivers to Develop a Conceptual Framework","volume":"9","author":"Pompilus","year":"2021","journal-title":"Oncol. Ther."},{"key":"ref_31","first-page":"615","article-title":"A Pilot Mixed-Methods Study of Malignant Pleural Mesothelioma Symptoms","volume":"49","author":"Walker","year":"2022","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"299","DOI":"10.2217\/fon-2022-0730","article-title":"A patient\u2019s perspective on the side effects of tyrosine kinase inhibitors in the treatment of advanced and metastatic gastrointestinal stromal tumors","volume":"19","author":"Venkatesan","year":"2023","journal-title":"Future Oncol."},{"key":"ref_33","first-page":"677","article-title":"The unmet needs of patients in the early rehabilitation stage after lung cancer surgery: A qualitative study based on Maslow\u2019s hierarchy of needs theory","volume":"31","author":"Yang","year":"2023","journal-title":"Support. Care Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1007\/s11136-025-03932-z","article-title":"A patient first perspective of sleep disturbance across therapeutic areas: A systematic literature review of qualitative studies","volume":"34","author":"Riedmann","year":"2025","journal-title":"Qual. Life Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5380","DOI":"10.1007\/s12325-025-03330-4","article-title":"Fatigue Experience in Oncology; a Targeted Qualitative Literature Review and Novel Patient-Centric Conceptual Model","volume":"42","author":"Carmichael","year":"2025","journal-title":"Adv. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1007\/s11136-011-0054-x","article-title":"Implementing patient-reported outcomes assessment in clinical practice: A review of the options and considerations","volume":"21","author":"Snyder","year":"2012","journal-title":"Qual. Life Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"S66","DOI":"10.1111\/j.1524-4733.2007.00269.x","article-title":"Patient-reported outcomes: Conceptual issues","volume":"10","author":"Rothman","year":"2007","journal-title":"Value Health"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/19\/3191\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:13:24Z","timestamp":1791951204000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/19\/3191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,2]]},"references-count":37,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["cancers18193191"],"URL":"https:\/\/doi.org\/10.3390\/cancers18193191","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,2]]}}}