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Relationships Among Daytime Napping and Fatigue, Sleep Quality, and Quality of Life in Cancer Patients

Sun, Jia-Ling PhD, RN; Lin, Chia-Chin PhD, RN

doi: 10.1097/NCC.0000000000000299

Background: The relationships among napping and sleep quality, fatigue, and quality of life (QOL) in cancer patients are not clearly understood.

Objective: The aim of the study was to determine whether daytime napping is associated with nighttime sleep, fatigue, and QOL in cancer patients.

Methods: In total, 187 cancer patients were recruited. Daytime napping, nighttime self-reported sleep, fatigue, and QOL were assessed using a questionnaire. Objective sleep parameters were collected using a wrist actigraph.

Results: According to waking-after-sleep-onset measurements, patients who napped during the day experienced poorer nighttime sleep than did patients who did not (t = −2.44, P = .02). Daytime napping duration was significantly negatively correlated with QOL. Patients who napped after 4 PM had poorer sleep quality (t = −1.93, P = .05) and a poorer Short-Form Health Survey mental component score (t = 2.06, P = .04) than did patients who did not. Fatigue, daytime napping duration, and sleep quality were significant predictors of the mental component score and physical component score, accounting for 45.7% and 39.3% of the variance, respectively.

Conclusions: Daytime napping duration was negatively associated with QOL. Napping should be avoided after 4 PM.

Implications for Practice: Daytime napping affects the QOL of cancer patients. Future research can determine the role of napping in the sleep hygiene of cancer patients.

Author Affiliations: Department of Nursing, Yuanpei University of Medical Technology, Hsinchu (Dr Sun); and School of Nursing, College of Nursing, Taipei Medical University, Taipei (Dr Lin), Taiwan.

This study was supported by the Ministry of Science and Technology (97-2314-B-038-044-MY3).

The authors have no conflicts of interest to disclose.

Correspondence: Chia-Chin Lin, PhD, RN, School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing St, Taipei 11031, Taiwan, Republic of China (

Accepted for publication June 3, 2015.

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