School of Social Work, College of Health and Human Sciences, Colorado State University, Fort Collins, CO, USA.
University of Northern Colorado Cancer Rehabilitation Institute, School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA.
Support Care Cancer. 2018 Jun;26(6):1833-1840. doi: 10.1007/s00520-017-4012-1. Epub 2017 Dec 20.
Sleep disturbances are recognized as a problem for many cancer patients, but little is known about the prevalence of sleep disorders among women hospitalized with breast cancer, or their relationship to in-hospital outcomes. The present study represents a first step toward determining the clinical significance of sleep disorders for hospitalized breast cancer patients with regard to complications, length of hospital stay, and mortality.
The relationships between sleep disorders and in-hospital outcomes among 84,424 hospitalized breast cancer patients were examined. This study analyzed the Nationwide Inpatient Sample (NIS) database (2007 to 2011) for all women ages 40 years and older with a primary discharge diagnosis of breast cancer and a secondary discharge diagnosis of sleep disorder. Odds ratios, estimates, and 95% confidence intervals were computed using multivariable regression adjusting for age, comorbidities, race, cancer stage, income, insurance type, residential region, year of discharge, and surgical treatment type.
Among women hospitalized with a primary diagnosis of breast cancer, 2% (n = 1807) also received a diagnosis of a sleep disorder during hospitalization, the majority of which were sleep-related breathing disorders (n = 1274). Although there was no significant association between having a diagnosis of a sleep disorder and in-hospital mortality, patients with a sleep disorder were more likely to also experience complications (OR = 1.58, 95% CI 1.29-1.34) and have longer hospital stays (mean = 0.44 days longer, 95% CI 0.25-0.63).
Hospitalized breast cancer patients with a sleep disorder were more likely to experience clinical complications and stay longer in the hospital. It remains an open and important question for future research whether interventions to improve sleep during hospitalization would help to improve clinical outcomes.
睡眠障碍被认为是许多癌症患者的一个问题，但对于住院乳腺癌女性中睡眠障碍的患病率及其与住院结果的关系知之甚少。本研究旨在确定睡眠障碍对住院乳腺癌患者并发症、住院时间和死亡率的临床意义，这是一个初步的尝试。
研究分析了 84424 例住院乳腺癌患者的睡眠障碍与住院结果之间的关系。本研究分析了 2007 年至 2011 年全国住院患者样本（NIS）数据库中所有年龄在 40 岁及以上、初次出院诊断为乳腺癌、二次出院诊断为睡眠障碍的女性患者。使用多变量回归，调整年龄、合并症、种族、癌症分期、收入、保险类型、居住地区、出院年份和手术治疗类型，计算比值比、估计值和 95%置信区间。
在因原发性乳腺癌住院的女性中，有 2%（n=1807）的患者在住院期间还被诊断为睡眠障碍，其中大多数为睡眠相关呼吸障碍（n=1274）。尽管患有睡眠障碍与住院期间死亡率之间没有显著关联，但患有睡眠障碍的患者更有可能出现并发症（OR=1.58，95%CI 1.29-1.34）和住院时间延长（平均延长 0.44 天，95%CI 0.25-0.63）。
患有睡眠障碍的住院乳腺癌患者更有可能出现临床并发症，住院时间更长。未来的研究仍然需要探讨是否通过干预措施改善住院期间的睡眠质量，是否有助于改善临床结局。
