Insomnia is a disabling, non-remitting condition, and a causal factor in the evolution and maintenance of physical and mental ill-health. It is the most reported mental health complaint in the UK and the most prevalent and clinically troubling side effect reported by patients with cancer. Insomnia has also been associated with significantly shorter overall cancer survival, independent of other prognostic factors, so it is important to identify and treat insomnia in cancer patients and where possible, mitigate its evolution into a persistent disorder.

This study aims to detect potential obstacles to the natural recovery of good sleep after diagnosis and treatment for bowel cancer. The innovative aspect of this proposal relates to the potential for prevention of insomnia and to the promotion of good sleep health as a central component of cancer-related quality of life. The exploration of insomnia development in a large cohort of bowel cancer patients will permit a useful assessment of the progression from normal sleep to acute sleep disturbance, to (potentially) persistent insomnia within a single, homogeneous group. Exploring the developmental trajectory of insomnia within bowel cancer also helps to inform sleep management protocols, specifically regarding when and how they would be most useful for patients.

This project comprises three related studies:

• systematic literature review
• quantitative evaluation of the developmental trajectory of insomnia following bowel cancer diagnosis
• qualitative exploration of patient’s experience of the impact of bowel cancer on sleep health