National Resource Center for Late Effects, Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, Norway.
Sleep Med. 2011 Jun;12(6):584-90. doi: 10.1016/j.sleep.2011.01.011.
In breast cancer survivors (BCSs) the relation between insomnia symptoms and arm/shoulder problems has hardly been investigated. In cross-sectional and longitudinal designs we examined this association in BCSs and in comparison to age-matched controls from the general population.
Our cross-sectional sample consisted of 337 BCSs stage II/III studied in 2004 at a median of 3.9 years after surgery combined with adjuvant radiotherapy and cytostatics/hormones. In 2007 248 (74%) BCSs were re-examined (median 2.5 years later). The responses of the 2004 sample were compared to those of 1685 controls.
Thirty percent of BCSs reported insomnia symptoms in 2004, and arm/shoulder problems were significantly associated with insomnia, as were established variables in bivariate analyses. In 2004 only regular use of hypnotics remained associated with insomnia in multivariate analysis. In bivariate analysis arm/shoulder pain and restricted mobility in 2004 were significant predictors of insomnia in 2007. Only insomnia in 2004 was a significant predictor in multivariate analysis. In bivariate analyses BCSs and controls had several common factors associated with insomnia, but only regular use of hypnotics was common in multivariate analysis.
Arm/shoulder problems are factors to consider in BCSs with insomnia, particularly arm/shoulder pain. Factors associated with insomnia in BCSs and general population controls are partially overlapping.
在乳腺癌幸存者（BCSs）中，失眠症状与手臂/肩部问题之间的关系几乎没有被研究过。在横断面和纵向设计中，我们在 BCSs 中以及与来自普通人群的年龄匹配对照者中检查了这种关联。
我们的横断面样本包括 337 名 II/III 期 BCSs，在手术后联合辅助放疗和细胞毒药物/激素治疗 3.9 年的中位数时于 2004 年进行研究。在 2007 年，有 248 名（74%）BCSs 接受了重新检查（中位数为 2.5 年后）。比较了 2004 年样本的反应与 1685 名对照者的反应。
2004 年，30%的 BCSs 报告有失眠症状，手臂/肩部问题与失眠明显相关，与双变量分析中的既定变量也相关。在多变量分析中，仅定期使用催眠药与失眠相关。在 2004 年的双变量分析中，手臂/肩部疼痛和活动受限是 2007 年失眠的显著预测因素。仅在 2004 年的失眠是多变量分析中的显著预测因素。在双变量分析中，BCSs 和对照组有几个与失眠相关的共同因素，但仅在多变量分析中定期使用催眠药是共同的。
手臂/肩部问题是 BCSs 失眠时需要考虑的因素，尤其是手臂/肩部疼痛。与 BCSs 和普通人群对照组失眠相关的因素部分重叠。
