Vincent A J, Ranasinha S, Sayakhot P, Mansfield D, Teede H J
* Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University , Clayton , Victoria.
Climacteric. 2014 Oct;17(5):598-604. doi: 10.3109/13697137.2014.900745. Epub 2014 May 25.
Treatment-induced early menopause occurs in > 80% of premenopausal women diagnosed with breast cancer. This study explored the relationship between vasomotor symptoms (VMS), sleep and mood in women aged 40-51 years with non-metastatic breast cancer.
Cross-sectional study using validated questionnaires (Greene Climacteric scale and Hospital Anxiety and Depression Scale, HADS). Women (n = 114) were recruited from the community and hospital outpatient clinics. Frequency determination and structural equation modeling (SEMod) were used to examine the relationship between the latent variables: VMS, anxiety, and depression, and the indicator variable: difficulty sleeping.
Participants' mean age was 47 years and 94% became menopausal after breast cancer diagnosis. Difficulty sleeping was reported by 82% of women with 46% reporting (Likert scale) 'quite a bit/extremely'. Most women reported night sweats (77% of women: 47% reporting 'quite a bit/extremely') and hot flushes (84% of women: 50% reporting 'quite a bit/extremely'). HADS scores indicated clinically relevant depression and anxiety in 98% and 99% of women, respectively. SEMod revealed that VMS contributed to difficulty sleeping (standardized coefficient = 0.54; p < 0.001) and difficulty sleeping mediated the relationship between VMS and anxiety (standardized coefficient = 0.34; p = 0.03). However, difficulty sleeping did not have a significant direct impact on depression (standardized coefficient = -0.03; p = 0.8), although anxiety was a strong predictor of depression (standardized coefficient = 0.83; p = 0.015).
VMS, sleep and mood disturbance are commonly experienced by younger women with breast cancer. Using SEMod, we demonstrate for the first time that VMS may directly influence sleep in these women. VMS may have an indirect effect on mood, partly mediated by sleep difficulty.
在确诊为乳腺癌的绝经前女性中，超过80%会因治疗导致过早绝经。本研究探讨了40 - 51岁非转移性乳腺癌女性血管舒缩症状（VMS）、睡眠与情绪之间的关系。
采用经过验证的问卷（格林更年期量表和医院焦虑抑郁量表，HADS）进行横断面研究。从社区和医院门诊招募了114名女性。使用频率测定和结构方程模型（SEMod）来检验潜在变量（VMS、焦虑和抑郁）与指标变量（睡眠困难）之间的关系。
参与者的平均年龄为47岁，94%的女性在乳腺癌诊断后进入更年期。82%的女性报告有睡眠困难，其中46%报告（李克特量表）“相当多/极其严重”。大多数女性报告有盗汗（77%的女性：47%报告“相当多/极其严重”）和潮热（84%的女性：50%报告“相当多/极其严重”）。HADS评分显示，分别有98%和99%的女性存在临床相关的抑郁和焦虑。SEMod显示，VMS导致睡眠困难（标准化系数 = 0.54；p < 0.001），睡眠困难介导了VMS与焦虑之间的关系（标准化系数 = 0.34；p = 0.03）。然而，睡眠困难对抑郁没有显著的直接影响（标准化系数 = -0.03；p = 0.8），尽管焦虑是抑郁的强预测因素（标准化系数 = 0.83；p = 0.015）。
患有乳腺癌的年轻女性普遍经历VMS、睡眠和情绪障碍。使用SEMod，我们首次证明VMS可能直接影响这些女性的睡眠。VMS可能对情绪有间接影响，部分是由睡眠困难介导的。
