Jung Dooyoung, Lee Kwang-Min, Kim Won-Hyoung, Lee Joo-Young, Kim Tae-Yong, Im Seock-Ah, Lee Kyung-Hun, Spiegel David, Hahm Bong-Jin
From the Department of Human Factors Engineering (Jung), Ulsan National Institute of Science and Technology, Ulsan, Korea; Department of Psychiatry and Behavioral Sciences (Jung, K-M Lee, Hahm), Seoul National University College of Medicine, Seoul, Korea; Department of Neuropsychiatry (K-M Lee, Hahm), Seoul National University Hospital, Seoul, Korea; Department of Psychiatry (W-H Kim), Inha University Hospital, Incheon, Korea; Department of Health Management (J-Y Lee), Armed Forces Medical Command, Seongnam, Korea; Department of Internal Medicine (T-Y Kim, Im, K-H Lee), Seoul National University Hospital, Seoul, Korea; Department of Internal Medicine (Im), Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute (T-Y Kim, Im, K-H Lee), Seoul National University, Seoul, Korea; Department of Psychiatry and Behavioral Sciences (Spiegel), Stanford University, Stanford, California.
Psychosom Med. 2016 Oct;78(8):959-965. doi: 10.1097/PSY.0000000000000372.
Risk factors for chemotherapy-induced nausea and vomiting (CINV) include older age, female sex, alcohol consumption, and a history of motion sickness. Although gastrointestinal symptoms are found to be related with sleep and mood in other conditions, little is known about their effects on CINV.
This prospective observational study recruited patients with early-stage breast cancer who had recovered from surgery before receiving a first cycle of anthracycline and cyclophosphamide-based chemotherapy. Candidate factors associated with CINV were assessed before chemotherapy by using the following: the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, the Epworth Sleepiness Scale, and the Hospital Anxiety and Depression Scale. Chemotherapy-induced nausea (CIN) and chemotherapy-induced vomiting (CIV) were defined according to a numeric rating scale (0-10) as follows: ≥3, nausea; ≥1, vomiting.
Between February 2012 and May 2014, data were collected from 198 patients. Chemotherapy-induced nausea occurred in 35.4% of patients, and CIV occurred in 31.3%. Chemotherapy-induced nausea was significantly associated with poor sleep quality (odds ratio [OR], 2.48; 95% confidence interval [CI], 1.13-5.46; p = 0.024) and pretreatment nausea (OR, 4.81; 95% CI, 1.84-12.62; p = 0.001). Likewise, CIV was significantly associated with poor sleep quality (OR, 2.64; 95% CI, 1.21-5.78; p = 0.015) and pretreatment nausea (OR, 3.07; 95% CI, 1.23-7.66; p = 0.016).
Poor sleep quality increases risk of CINV in patients with breast cancer. Sleep problems should be assessed and considered in the management of CINV.
化疗引起的恶心和呕吐（CINV）的风险因素包括年龄较大、女性、饮酒和晕动病史。尽管在其他情况下发现胃肠道症状与睡眠和情绪有关，但关于它们对CINV的影响知之甚少。
这项前瞻性观察性研究招募了早期乳腺癌患者，这些患者在接受基于蒽环类药物和环磷酰胺的首个化疗周期之前已从手术中康复。在化疗前使用以下方法评估与CINV相关的候选因素：匹兹堡睡眠质量指数、失眠严重程度指数、爱泼华嗜睡量表和医院焦虑抑郁量表。化疗引起的恶心（CIN）和化疗引起的呕吐（CIV）根据数字评分量表（0-10）定义如下：≥3为恶心；≥1为呕吐。
2012年2月至2014年5月期间，收集了198例患者的数据。35.4%的患者发生了化疗引起的恶心，31.3%的患者发生了CIV。化疗引起的恶心与睡眠质量差（比值比[OR]，2.48；95%置信区间[CI]，1.13-5.46；p = 0.024）和化疗前恶心（OR，4.81；95%CI，1.84-12.62；p = 0.001）显著相关。同样，CIV与睡眠质量差（OR，2.64；95%CI，1.21-5.78；p = 0.015）和化疗前恶心（OR，3.07；95%CI，1.23-7.66；p = 0.016）显著相关。
睡眠质量差会增加乳腺癌患者发生CINV的风险。在CINV的管理中应评估并考虑睡眠问题。
