The prevalence, key causes and management of insomnia in palliative care patients

J Pain Symptom Manage. 2004 Apr;27(4):316-21. doi: 10.1016/j.jpainsymman.2003.09.010.


In a prospective audit, the prevalence, key causes and treatment of insomnia prior to admission were evaluated in a population of hospice patients using a questionnaire based on a review article of key features related to insomnia in the palliative care setting. Seventy-four patients completed the questionnaire. Fifty-two (70%) patients had insomnia symptoms. Uncontrolled physical symptoms, most often pain (15 patients), were the commonest cause of insomnia, cited by 31 (60%) sleep-disturbed patients. Thirteen (62%) of 21 patients who had been prescribed hypnotic medication reported an improvement with the prescribed medication. Twenty (38%) of the 52 patients with insomnia suggested that improved symptom control would improve their sleep, and only two (4%) suggested the need for more hypnotic medication. We conclude that insomnia is a common symptom in terminally ill patients and that improved symptom control should be a priority in the management of insomnia in this group of patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Hospices
  • Humans
  • Male
  • Middle Aged
  • Palliative Care*
  • Prevalence
  • Sleep Initiation and Maintenance Disorders / epidemiology
  • Sleep Initiation and Maintenance Disorders / etiology*
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Surveys and Questionnaires