Associations Between Nutritional Status, Sleep Quality, and Clinical Factors in Patients With Metastatic Prostate Cancer

PURPOSE – Malnutrition and poor sleep quality are common but underrecognized issues among patients with metastatic prostate cancer (mPC). This study aimed to examine the associations between nutritional status, sleep quality, and clinical outcomes in men with mPC. METHODS – In this cross-sectional study, 91 men with stage IV prostate cancer were evaluated for nutritional status using the Subjective Global Assessment (SGA) and sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Clinical and laboratory parameters, including albumin, hemoglobin, C-reactive protein (CRP), and quality-of-life scores (EORTC QLQ-C30 and QLQ-PR25), were compared across SGA categories and sleep quality groups. Multivariable logistic regression was used to identify predictors of poor sleep (PSQI >5).RESULTS – Overall, 60.4% of patients were castration-resistant, and 38.5% were severely malnourished (SGA C). Poor sleep quality was observed in 65.9% of patients and was significantly more prevalent among those with moderate-to-severe malnutrition (P < .001). Patients with worse nutritional status exhibited lower albumin and hemoglobin levels, higher CRP, poorer performance status, and worse quality-of-life scores across all domains (P < .001). In multivariable analysis, independent predictors of poor sleep included higher CRP (odds ratio [OR], 1.33 [95% CI, 1.11 to 1.61), lower hemoglobin (OR, 0.66 [95% CI, 0.46 to 0.93]), and poorer nutritional status (SGA C v A, OR, 5.06 [95% CI, 1.70 to 15.05]).CONCLUSION – Malnutrition and systemic inflammation are closely linked with impaired sleep quality and diminished quality of life in mPC. Nutritional screening and targeted interventions may represent an important component of supportive care for optimizing well-being in this population. © 2026 American Society of Clinical Oncology