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Lookup NU author(s): Dr Peipei Liu, Professor Linda SharpORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s) 2026.Purpose: Sleep disturbance is a common issue among patients with head and neck cancer (HNC); it may exacerbate symptom burden and reduce quality of life. However, previous evidence on sleep disturbance trends and predictors is limited; many studies have been small and/or cross-sectional. Therefore, using data from a large, prospective, nationwide cohort, we investigated clinically important sleep disturbance during the first year following diagnosis and the factors associated with it. Methods: Head and Neck 5000 (HN5000) recruited HNC patients newly diagnosed in the UK during 2011–2014, with longitudinal follow-up at 4 months and 12 months post-recruitment. Sociodemographic and clinical data were collected via questionnaires and electronic medical records. Patients completed the EORTC QLQ-C30 questionnaire at baseline (pre-treatment) and follow-up, from which sleep disturbance scores (ranging 0–100) were derived. Following past work, clinically important sleep disturbance was defined as a score of 50 or higher. Multivariable mixed-effects logistic regression was used to investigate time trends and identify associated clinical, sociodemographic and lifestyle factors. Results: At baseline, 861 of 2,867 (30.0%) non-recurrent HNC patients reported clinically important sleep disturbance; this proportion remained unchanged at 4 months (29.9%) but decreased at 12 months (23.3%). In the multivariable model, after adjusting for time-point, the odds of having clinically important sleep disturbance over 12 months were significantly increased among females, those living in the most deprived areas, those with comorbidities, those receiving chemoradiotherapy only, and current smokers. In addition, depression at baseline was strongly associated with increased odds of clinically significant sleep disturbance. Older patients (≥ 50) and current alcohol drinkers had lower odds of clinically significant sleep disturbance. Conclusions: In this longitudinal clinical cohort, we found a high prevalence of clinically important sleep disturbance over time, especially among patients with depression at baseline. These findings highlight the need for targeted interventions and support for HNC survivors, especially for subgroups at higher risk. Implications for Cancer Survivors: For HNC patients, sleep disturbance should be screened for and managed from diagnosis through treatment and into survivorship.
Author(s): Liu P, Patterson JM, Harding S, Watson L-J, Hurley K, Thomas SJ, Sharp L
Publication type: Article
Publication status: Published
Journal: Journal of Cancer Survivorship
Year: 2026
Pages: epub ahead of print
Online publication date: 28/07/2026
Acceptance date: 08/07/2026
Date deposited: 10/08/2026
ISSN (print): 1932-2259
ISSN (electronic): 1932-2267
Publisher: Springer
URL: https://doi.org/10.1007/s11764-026-02084-4
DOI: 10.1007/s11764-026-02084-4
Data Access Statement: The data that support the findings of this study are available from Head and Neck 5000. Further information may be found on the Head and Neck 5000 website: [https://www.headandneck5000. org.uk/information-for-researchers/](https:/www.headandneck5000. org.uk/information-for-researchers)
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