Sen Abhijit, Opdahl Signe, Strand Linn Beate, Vatten Lars Johan, Laugsand Lars Erik, Janszky Imre
From the Department of Public Health and General Practice (Sen, Opdahl, Strand, Vatten, Laugsand, Janszky), Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Internal Medicine (Laugsand), St. Olav's hospital, Trondheim, Norway; and Department of Public Health Sciences (Janszky), Karolinska Institutet, Stockholm, Sweden.
Psychosom Med. 2017 May;79(4):461-468. doi: 10.1097/PSY.0000000000000417.
The association of insomnia with subsequent breast cancer risk is largely unknown. Therefore, we assessed whether different symptoms of insomnia and their combination are associated with incident breast cancer in a large population-based study.
In a prospective cohort study, 33,332 women were followed to monitor the occurrence of their first invasive breast cancer identified by the Cancer Registry of Norway. Insomnia symptoms including () nonrestorative sleep and () difficulty initiating and () maintaining sleep were self-reported using a study specific measure reflecting the current Diagnostic and Statistical Manual of Mental Disorders criteria. Hazard ratios and 95% confidence intervals were calculated using multiadjusted Cox proportional hazards models.
A total of 862 incident breast cancer cases occurred during a mean follow-up of 14.7 years. No consistent association was observed between the individual insomnia symptoms and breast cancer risk. However, compared to women reporting no insomnia complaints, those who reported having all three aspects of insomnia simultaneously were at increased risk (hazard ratio, 2.38; 95% confidence interval = 1.11-5.09).
Our results suggest that having only some aspects of insomnia may not predispose someone to breast cancer. In contrast, experiencing all insomnia symptoms simultaneously might confer considerable excess risk.
失眠与后续患乳腺癌风险之间的关联在很大程度上尚不清楚。因此，在一项基于大规模人群的研究中，我们评估了失眠的不同症状及其组合是否与乳腺癌发病相关。
在一项前瞻性队列研究中，对33332名女性进行随访，以监测她们首次被挪威癌症登记处确诊的浸润性乳腺癌的发生情况。使用一项反映当前《精神疾病诊断与统计手册》标准的特定研究方法，让她们自我报告失眠症状，包括（）睡眠未恢复感、（）入睡困难和（）维持睡眠困难。使用多因素调整的Cox比例风险模型计算风险比和95%置信区间。
在平均14.7年的随访期间，共发生了862例乳腺癌发病病例。未观察到个体失眠症状与乳腺癌风险之间存在一致的关联。然而，与未报告失眠症状的女性相比，同时报告有所有三个失眠方面症状的女性风险增加（风险比，2.38；95%置信区间 = 1.11 - 5.09）。
我们的结果表明，仅有某些失眠方面的症状可能不会使某人易患乳腺癌。相比之下，同时出现所有失眠症状可能会带来相当大的额外风险。
