Fontes Filipa, Pereira Susana, Costa Ana Rute, Gonçalves Marta, Lunet Nuno
ISPUP-EPIUnit, University of Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal.
Portuguese Institute of Oncology of Porto, Rua Dr. António Bernardino de Almeida, 4200-075, Porto, Portugal.
Support Care Cancer. 2017 Nov;25(11):3529-3536. doi: 10.1007/s00520-017-3777-6. Epub 2017 Jun 16.
The increasing number of women living longer with potential side effects of breast cancer treatment highlights the need of a comprehensive assessment of its burden. Therefore, we aimed to quantify the relation between different breast cancer treatments and sleep quality 1 year after diagnosis.
A cohort of 502 newly diagnosed breast cancer patients was prospectively followed. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI), at baseline and at the 1-year follow-up. Odds ratios (OR) were computed to quantify the association between patient characteristics and poor sleep quality (PSQI score >5) at baseline, and relative risks (RR) were computed for the association between treatments and the occurrence of poor sleep quality at 1 year.
A total of 60.2% of the patients had poor sleep quality before breast cancer treatments, especially those with anxiety [OR = 2.86, 95% confidence interval (95%CI) 1.92 to 4.27] or depression (OR = 5.25, 95%CI 2.01 to 13.67). Radiotherapy increased the risk of poor sleep quality at 1 year (RR = 3.71, 95%CI 1.15 to 11.96, for a cumulative dose >50 Gy) and there was a tendency for a higher risk in those submitted to chemotherapy, although not statistically significant.
Our study shows that sleep disturbances are frequent before cancer treatment and confirms their co-occurrence with other medical conditions, such as anxiety and depression. Different breast cancer treatments increase the risk of impaired sleep quality, therefore contributing to the global disability associated with cancer treatments.
随着越来越多的女性在乳腺癌治疗后长期存活且伴有潜在副作用，凸显了全面评估其负担的必要性。因此，我们旨在量化不同乳腺癌治疗方法与诊断后1年睡眠质量之间的关系。
对502例新诊断的乳腺癌患者进行前瞻性随访。在基线和1年随访时，采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。计算优势比（OR）以量化患者特征与基线时睡眠质量差（PSQI评分>5）之间的关联，并计算相对风险（RR）以评估治疗与1年时睡眠质量差的发生之间的关联。
共有60.2%的患者在乳腺癌治疗前睡眠质量差，尤其是那些伴有焦虑[OR = 2.86，95%置信区间（95%CI）1.92至4.27]或抑郁（OR = 5.25，95%CI 2.01至13.67）的患者。放疗增加了1年时睡眠质量差的风险（对于累积剂量>50 Gy，RR = 3.71，95%CI 1.15至11.96），接受化疗的患者有更高风险的趋势，尽管无统计学意义。
我们的研究表明，睡眠障碍在癌症治疗前很常见，并证实了它们与焦虑和抑郁等其他疾病同时存在。不同的乳腺癌治疗方法会增加睡眠质量受损的风险，因此导致了与癌症治疗相关的整体残疾。
