Subjective and Objective Sleep Quality and Associated Factors in Patients with Cancer During Particle Therapy: A Cross-Sectional Study

Background and Objectives: Sleep quality during particle therapy remains understudied. We assessed subjective and objective sleep quality, their correlations, and associated factors. Methods: This single-center cross-sectional study included 443 patients assessed using the Pittsburgh Sleep Quality Index (PSQI) and seven-day wrist actigraphy. Spearman correlations and multivariable logistic regression were used. Results: Among 443 patients, 229 (51.7%) had subjective poor sleep quality and 269 (60.7%) had objective poor sleep quality. Corresponding PSQI and actigraphy-derived sleep measures showed positive Spearman correlations for total sleep time (TST) (ρ = 0.417, p < 0.001), sleep efficiency (SE) (ρ = 0.360, p < 0.001), and sleep-onset latency (SOL) (ρ = 0.273, p < 0.001). In the multivariable model for subjective poor sleep quality, older age (adjusted odds ratio [aOR] = 1.039 per year; 95% confidence interval [CI], 1.013–1.067; p = 0.004), greater symptom burden (aOR = 1.044 per ESAS-r Cancer point; 95% CI, 1.016–1.073; p = 0.002), and hypnotic medication use before particle therapy (aOR = 4.040 versus no use; 95% CI, 1.496–10.909; p = 0.006) were associated with higher odds, whereas healthier sleep beliefs were associated with lower odds (aOR = 0.907 per DBAS-16 point; 95% CI, 0.882–0.933; p < 0.001). Annual household income was also associated with subjective poor sleep quality (overall p = 0.043); specifically, patients earning CNY 200,000–500,000 had higher odds than those earning less than CNY 200,000 (aOR = 2.165; 95% CI, 1.160–4.042; p = 0.015). In the model for objective poor sleep quality, older age (aOR = 1.032 per year; 95% CI, 1.011–1.053; p = 0.003), greater symptom burden (aOR = 1.028 per ESAS-r Cancer point; 95% CI, 1.005–1.052; p = 0.015), and male sex (aOR = 1.904 versus female sex; 95% CI, 1.123–3.230; p = 0.017) were associated with higher odds, while healthier sleep beliefs were associated with lower odds (aOR = 0.979 per DBAS-16 point; 95% CI, 0.959–0.999; p = 0.044). Conclusions: Subjective and objective poor sleep quality were common during particle therapy. Questionnaire screening supplemented by actigraphy may support more comprehensive sleep-quality assessment in oncology nursing.