Nationwide database analysis of insomnia, depression, and sleeping pill prescriptions in hepatocellular carcinoma patients

Abstract

Objective

To clarify the status of insomnia and depression and the prescription of sleeping pills in hepatocellular carcinoma (HCC) patients before and after HCC diagnosis and treatment.

Methods

Patients’ data from a Japanese health insurance claims database were analyzed retrospectively to determine the incidence of insomnia and depression and their association with sleeping pill prescriptions during the 6 months before and after HCC diagnosis and treatment.

Results

A total of 9,109 HCC patients (median age at diagnosis = 71.5 years, 68.1% male) were analyzed. The incidences of insomnia and depression increased significantly after HCC diagnosis. Insomnia was reported in 15.0% of patients before diagnosis, and it increased to 27.6% after diagnosis. Similarly, depression was reported in 6.3% and 11.3% before and after diagnosis, respectively. The incidences of insomnia and depression before diagnosis were higher in patients with concomitant liver diseases including hepatitis, cirrhosis, and hepatic encephalopathy. However, the rate of sleeping pill prescription was significantly lower in patients with concomitant liver diseases after diagnosis. The incidence of fracture was higher in insomnia or depression patients than others and in patients treated with sleeping pills than without before and after diagnosis.

Conclusions

HCC patients had increased risks of insomnia and depression after diagnosis. The high risk of fracture in HCC patients with insomnia and depression and treated with sleeping pills suggests that it is difficult to optimize the management of HCC patients, especially those with concomitant liver diseases.

Keywords:

• Hepatocellular carcinoma
• insomnia
• depression
• sleeping pills
• fracture

Transparency

Declaration of funding

This work was funded by Eisai Co. Ltd. The funder was involved in the collection, analysis, and interpretation of data, the writing of the report, and the decision to submit the paper for publication.

Declaration of financial/other relationships

All authors report personal fees from Eisai Co. Ltd. during the conduct of the study and personal fees from Eisai Co. Ltd. outside the submitted work. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

The authors would like to thank FORTE Science Communications (Tokyo, Japan) for writing and editorial support. Funding for this support was provided by Eisai Co. Ltd.

Data availability statement

All data disclosed in this manuscript were generated from the Japanese health insurance claims database provided by Medical Data Vision Co., Ltd. (MDV; Tokyo, Japan). All information referred to in the manuscript text is disclosed in the figure and tables provided.