Department of Psychiatry and Health Behavior,Georgia Cancer Center at Augusta University,Augusta,Georgia,USA.
Millennium Health,San Diego,California,USA.
Palliat Support Care. 2018 Jun;16(3):325-334. doi: 10.1017/S1478951517000311. Epub 2017 May 16.
ABSTRACTObjective:Sleep can affect quality of life (QoL) during cancer survivorship, and symptoms related to poor sleep can be exacerbated. We examined the prevalence, severity, and nature of subjective sleep complaints in women surviving stage I-III breast cancer who were 1-10 years posttreatment. We also examined the demographic, medical, physical, and psychosocial correlates of poor sleep in these women in order to identify the subgroups that may be most in need of intervention.
A total of 200 patients at a comprehensive cancer center who were 1-10 years posttreatment for primary stage I-III breast cancer with no evidence of disease at the time of enrollment completed a battery of questionnaires on demographics, sleep, physical symptoms, mood, cancer-specific fears, and QoL.
The women had a mean age of 57 years (SD = 10.0), with a mean of 63.3 months (SD = 28.8) of post-cancer treatment. Some 38% of these patients were identified as having poor-quality sleep. Women with poor sleep took longer to fall asleep, had more awakenings, and acquired 2 hours less sleep per night than those with good sleep. They also had a lower QoL, greater severity of pain, more concerns about health and recurrence, and increased vasomotor symptoms (p < 0.05). Daytime sleepiness and depression were found to be not significantly correlated with sleep quality.
Many breast cancer survivors had severe subjective insomnia, and several breast cancer survivor subgroups were identified as having members who might be most in need of sleep-improvement interventions. Addressing physical symptoms (e.g., vasomotor symptoms and pain) and providing education about the behavioral, social, environmental, and medical factors that affect sleep could result in substantial improvement in the life course of breast cancer survivors.
摘要
睡眠会影响癌症幸存者的生活质量（QoL），与睡眠质量差相关的症状可能会加剧。我们研究了 1-10 年癌症治疗后处于 I-III 期乳腺癌生存阶段的女性中主观睡眠抱怨的流行率、严重程度和性质。我们还研究了这些女性中睡眠质量差的人口统计学、医学、身体和心理社会相关因素，以便确定最需要干预的亚组。
在一个综合癌症中心，共有 200 名处于 I-III 期乳腺癌治疗后 1-10 年且在入组时无疾病证据的患者完成了一系列关于人口统计学、睡眠、身体症状、情绪、癌症特定恐惧和生活质量的问卷。
这些女性的平均年龄为 57 岁（SD=10.0），癌症治疗后平均 63.3 个月（SD=28.8）。这些患者中有 38%被确定为睡眠质量差。睡眠质量差的女性入睡时间更长，醒来次数更多，每晚睡眠减少 2 小时。她们的生活质量也更低，疼痛更严重，对健康和复发的担忧更多，血管舒缩症状增加（p<0.05）。白天嗜睡和抑郁与睡眠质量没有明显相关性。
许多乳腺癌幸存者有严重的主观失眠，并且确定了一些乳腺癌幸存者亚组，其中一些成员可能最需要进行睡眠改善干预。解决身体症状（如血管舒缩症状和疼痛），并提供有关影响睡眠的行为、社会、环境和医学因素的教育，可以显著改善乳腺癌幸存者的生活质量。
