Palesh Oxana Gronskaya, Collie Kate, Batiuchok Daniel, Tilston Jackie, Koopman Cheryl, Perlis Michael L, Butler Lisa D, Carlson Robert, Spiegel David
University of Rochester, Rochester, NY 14642, United States.
Biol Psychol. 2007 Apr;75(1):37-44. doi: 10.1016/j.biopsycho.2006.11.002. Epub 2006 Dec 12.
Sleep disturbances are common among women with breast cancer and can have serious consequences. The present study examined depression, pain, life stress, and participation in group therapy in relation to sleep disturbances in a sample of women with metastatic breast cancer.
Ninety-three women with metastatic breast cancer participated in a large intervention trial examining the effect of the group therapy on their symptoms. They completed measures of depression, pain, life stress, and sleep disturbance at baseline, 4, 8 and 12 months.
The results showed that higher initial levels of depression at baseline predicted problems associated with getting up in the morning, waking up during the night, and daytime sleepiness. Increases in depression over the course of 12 months were associated with fewer hours of sleep, more problems with waking up during the night and more daytime sleepiness. Higher levels of pain at baseline predicted more problems getting to sleep. Increases in pain predicted more difficulty getting to sleep and more problems waking up during the night. Greater life stress at baseline predicted more problems getting to sleep and more daytime sleepiness.
Depression, pain, and life stress scores were each associated with different types of negative change in self-reported sleep disturbances. Depression, especially worsening depression, was associated with the greatest number of types of negative change. The relationships found between sleep disturbance and depression, pain, and life stress suggest specific ways to address the problem of sleep disturbance for women with metastatic breast cancer and show how different types of disturbed sleep may be clinical markers for depression, pain, or life stress in this population.
睡眠障碍在乳腺癌女性患者中很常见，且可能产生严重后果。本研究调查了转移性乳腺癌女性样本中抑郁、疼痛、生活压力以及参与团体治疗与睡眠障碍之间的关系。
93名转移性乳腺癌女性参与了一项大型干预试验，该试验考察团体治疗对她们症状的影响。她们在基线、4个月、8个月和12个月时完成了抑郁、疼痛、生活压力和睡眠障碍的测量。
结果显示，基线时较高的初始抑郁水平预示着与早晨起床、夜间醒来及日间嗜睡相关的问题。在12个月期间抑郁程度增加与睡眠时间减少、夜间醒来问题增多以及日间嗜睡增多有关。基线时较高的疼痛水平预示着入睡困难增多。疼痛加剧预示着入睡更困难以及夜间醒来问题更多。基线时更大的生活压力预示着入睡困难增多以及日间嗜睡增多。
抑郁、疼痛和生活压力评分分别与自我报告的睡眠障碍的不同类型的负面变化相关。抑郁，尤其是抑郁加重，与最多类型的负面变化相关。睡眠障碍与抑郁、疼痛和生活压力之间的关系为解决转移性乳腺癌女性的睡眠障碍问题提供了具体方法，并展示了不同类型的睡眠障碍如何可能成为该人群抑郁、疼痛或生活压力的临床指标。
