使用多导睡眠图评估接受辅助治疗（化疗和/或放疗）的乳腺癌患者的睡眠模式障碍。

Evaluation of sleep pattern disorders in breast cancer patients receiving adjuvant treatment (chemotherapy and/or radiotherapy) using polysomnography.

作者信息

Tag Eldin El-Sayed, Younis Samar Galal, Aziz Lamiss Mohamed Abd El, Eldin Amr Tag, Erfan Sherif Tarek

机构信息

Department of Neurology, Tanta University Hospital, Tanta, Gharbia, Egypt.

出版信息

J BUON. 2019 Mar-Apr;24(2):529-534.

PMID:31128001

Abstract

PURPOSE

To assess sleep disturbance patterns in breast cancer patients receiving adjuvant radiotherapy and/or chemotherapy in comparison to normal subjects, and their impact on quality of life.

METHODS

Seventy-four histologically proven breast cancer patients of both genders, aged 30 to 65 years, were classified into 2 groups. First group: 26 patients with breast cancer before receiving any treatment. Second group: 48 breast cancer patients, subdivided into group A (24 patients with adjuvant chemotherapy), and group B (24 patients with adjuvant radiotherapy). A control group consisted of 24 healthy individuals matched in age and sex with patient groups. Clinical assessment of sleep was done using the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and one night Polysomnography (NPSG).

RESULTS

No statistically significant difference regarding age and sex was found compared to control group. The severity of insomnia (ISI) was 29.2%, 4.2%, 7.7% and 0% for patients who received chemotherapy and/or radiotherapy, and comparison of patients without treatment and the control group showed statistical significance. Excessive daytime sleepiness was 37.5%, 25%, 26.9% and 0% for patients who received chemotherapy and/or radiotherapy, before receiving treatment, and the control groups respectively, the difference been significant. Comparison of patients who received treatment with those who did not and the control groups showed significant shortening of total sleep time, decrease of sleep efficiency and lengthening of sleep latency. Significant lengthening in stage 2 of non-rapid eye movement (NREM), while insignificant lengthening in stages 1, 3 and 4 of NREM sleep was noted. Significant reduction of rapid eye movement (REM) and total sleep time percentage were observed. Sleep apnea was insignificantly more common in breast cancer patients compared to healthy controls.

CONCLUSION

Sleep-related changes in breast cancer patients should be used in planning best supportive care.

摘要

目的

评估接受辅助放疗和/或化疗的乳腺癌患者与正常受试者相比的睡眠障碍模式及其对生活质量的影响。

方法

74例经组织学证实的年龄在30至65岁之间的乳腺癌患者，分为两组。第一组：26例未接受任何治疗的乳腺癌患者。第二组：48例乳腺癌患者，再细分为A组（24例接受辅助化疗的患者）和B组（24例接受辅助放疗的患者）。对照组由24名年龄和性别与患者组相匹配的健康个体组成。使用失眠严重程度指数（ISI）、爱泼华嗜睡量表（ESS）和一晚多导睡眠图（NPSG）对睡眠进行临床评估。

结果

与对照组相比，在年龄和性别方面未发现统计学上的显著差异。接受化疗和/或放疗的患者失眠严重程度（ISI）分别为29.2%、4.2%、7.7%和0%，未接受治疗的患者与对照组比较显示有统计学意义。接受化疗和/或放疗的患者、治疗前患者及对照组白天过度嗜睡分别为37.5%、25%、26.9%和0%，差异有统计学意义。接受治疗的患者与未接受治疗的患者及对照组比较显示总睡眠时间显著缩短、睡眠效率降低和睡眠潜伏期延长。非快速眼动（NREM）睡眠第2期显著延长，而NREM睡眠第1、3和4期延长不显著。快速眼动（REM）和总睡眠时间百分比显著降低。与健康对照组相比，睡眠呼吸暂停在乳腺癌患者中稍常见，但无统计学意义。