Insomnia in Cancer Care: Analyzing Oncologists’ Knowledge and Practice in Singapore

Introduction: Insomnia is a common but often underdiagnosed and undertreated condition among cancer patients, significantly impacting their quality of life (QoL). Oncologists play a crucial role in managing insomnia, yet their knowledge and practices in this area remain unclear. This study aims to assess the current practices of oncologists in Singapore regarding insomnia management and to identify areas where additional education may be needed. Methods: We conducted a cross-sectional survey of practicing medical and radiation oncologists in Singapore. The survey, based on the 2023 ESMO Clinical Practice Guideline for managing insomnia in adult cancer patients, included 12 multiple-choice, checkbox, and open-ended questions. Data were analyzed descriptively to identify trends in screening, assessment, and management of insomnia among oncologists. Results: A total of 25 oncologists responded to the survey. The majority (84%) do not routinely screen for sleep disturbances, and only a small fraction uses validated tools to assess insomnia severity. Time constraints and a lack of knowledge were identified as the primary barriers to comprehensive sleep assessments. Pharmacological treatments, particularly melatonin and Z-class drugs, were commonly initiated, with 32% of oncologists using them as first-line therapy. Non-pharmacological strategies, such as cognitive behavioral therapy for insomnia, were underutilized. Additionally, many oncologists expressed uncertainty about when to refer patients to sleep specialists, indicating a gap in their training and confidence in managing insomnia. Conclusion: This study reveals significant gaps in the routine screening and comprehensive management of insomnia among oncologists in Singapore. Despite the high prevalence of sleep disturbances in cancer patients, oncologists often prioritize other symptoms and lack the necessary tools and knowledge to address insomnia effectively. The findings underscore the need for targeted educational interventions to enhance oncologists’ competence in diagnosing and managing insomnia, ultimately improving patient care.