Department of Psychology, Sam Houston State University, Huntsville, TX, USA.
Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Support Care Cancer. 2021 May;29(5):2601-2611. doi: 10.1007/s00520-020-05777-3. Epub 2020 Sep 22.
Disturbed sleep is common among breast cancer survivors. Identifying patients at risk for disturbed sleep and its sequelae will aid in improving screening and intervention strategies to improve sleep and cancer-related quality of life (QOL).
Women with stages I-III breast cancer undergoing neoadjuvant or adjuvant chemotherapy (N = 415) reported subjectively assessed sleep quality (PSQI) and actigraphy-assessed wake after sleep onset (AAS-WASO), total sleep time (AAS-TST), and sleep efficiency (AAS-SE), sociodemographic, and clinical characteristics and completed questionnaires assessing physical and mental health QOL at study entry and 3, 6, 12, and 15 months later.
Being from a racially/ethnically underserved population was associated with poorer sleep in all indices (p's < .04). Lower income was associated with poorer subjective sleep and greater AAS-WASO (p's < .02). BMI was associated with lower AAS-SE (p < .001). Baseline subjective sleep complaints were positively associated with depression, fatigue, and health-related QOL and cancer-related symptoms across follow-up (p's < 0.05). Baseline AAS-WASO was positively associated with anxiety and negatively associated with physical health-related QOL at the 3-month follow-up (p's < .001). Baseline AAS-WASO and AAS-SE were associated with mental health-related QOL at the 6-month follow-up (p's < .05).
In keeping with previous health disparity research, racially/ethnically underserved populations, lower household income, and higher BMI were associated with increased risk for disturbed sleep. Sleep disturbance may have long-term effects on multiple aspects of QOL for women undergoing treatment for breast cancer. Results may inform strategies to identify patients at greatest risk for disturbed sleep and its sequelae.
乳腺癌幸存者中常见睡眠障碍。识别有睡眠障碍风险及其后果的患者将有助于改善筛查和干预策略，以改善睡眠和癌症相关生活质量（QOL）。
接受新辅助或辅助化疗的 I-III 期乳腺癌女性（N=415）报告了主观评估的睡眠质量（PSQI）和活动记录仪评估的睡眠后觉醒时间（AAS-WASO）、总睡眠时间（AAS-TST）和睡眠效率（AAS-SE）、社会人口统计学和临床特征，并在研究开始时以及 3、6、12 和 15 个月后完成了评估身心健康 QOL 的问卷。
来自种族/民族服务不足人群的患者在所有指标上的睡眠质量均较差（p 值均<.04）。收入较低与主观睡眠质量较差和 AAS-WASO 增加有关（p 值均<.02）。BMI 与较低的 AAS-SE 相关（p<0.001）。基线主观睡眠问题与抑郁、疲劳和健康相关 QOL 以及癌症相关症状在随访期间呈正相关（p 值均<.05）。基线 AAS-WASO 与 3 个月随访时的焦虑呈正相关，与身体健康相关 QOL 呈负相关（p 值均<.001）。基线 AAS-WASO 和 AAS-SE 与 6 个月随访时的心理健康相关 QOL 相关（p 值均<.05）。
与之前的健康差异研究一致，种族/民族服务不足人群、较低的家庭收入和较高的 BMI 与睡眠障碍风险增加相关。睡眠障碍可能对接受乳腺癌治疗的女性的 QOL 多个方面产生长期影响。研究结果可能为确定睡眠障碍及其后果风险最大的患者提供策略。
