Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, CA, USA.
Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA.
Int J Behav Med. 2021 Feb;28(1):140-150. doi: 10.1007/s12529-020-09950-0. Epub 2021 Feb 17.
Sleep disturbances are associated with numerous mood disorders. Similarly, anxiety and depression are associated with modulation of the psychoneuroimmune (PNI) axis. This study hypothesized that changes in both monitored and self-reported measures of sleep would relate to changes in circulating cytokine levels in an emotionally distressed population of cervical cancer survivors.
Biospecimens, patient-reported outcome (PRO) measures, and actigraphy were collected from cervical cancer survivors enrolled in a biobehavioral clinical trial. Longitudinal changes over a 4-month period were examined. Sleep time measured by actigraphy and PRO were analyzed for correlative changes with emotional distress and serum cytokines (n = 71).
Longitudinal change in the actigraph measure of sleep time was inversely associated with changes in depression and anxiety (test for linear trend, p = 0.02 and p = 0.05 respectively), as well as acute-phase response/pro-inflammatory cytokines (test for linear trend, p = 0.003, interleukin (IL)-2; 0.022, IL-1β; 0.0002, IL-6; and 0.049, tumor necrosis factor α). Conversely, changes in self-reported sleep problems were related to an increase in depression and anxiety (p = 0.001 and p = 0.01 respectively), the T helper 2 (Th2) cytokine IL-5 (p = 0.027), and the counter-regulatory cytokine IL-10 (0.016).
This study showed that an increase in sleep time or decrease in sleep problems corresponded with a reduction in self-reported emotional distress and attenuation of pro-inflammatory, Th2, and counter-regulatory cytokines. Our results support sleep measurement as a meaningful biobehavioral variable in cancer survivorship. This study also indicates that sleep investigators should be aware that choice of methodology might influence concordance with different classes of immune parameters.
睡眠障碍与许多情绪障碍有关。同样，焦虑和抑郁与心理神经免疫（PNI）轴的调节有关。本研究假设，在情绪困扰的宫颈癌幸存者人群中，监测到的和自我报告的睡眠变化与循环细胞因子水平的变化有关。
从参加生物行为学临床试验的宫颈癌幸存者中收集生物样本、患者报告的结局（PRO）测量值和活动记录仪。检查了 4 个月期间的纵向变化。分析了活动记录仪和 PRO 测量的睡眠时间与情绪困扰和血清细胞因子的相关变化（n=71）。
睡眠时间的活动记录仪测量的纵向变化与抑郁和焦虑的变化呈负相关（线性趋势检验，p=0.02 和 p=0.05），以及急性期反应/促炎细胞因子（线性趋势检验，p=0.003，白细胞介素（IL）-2；0.022，IL-1β；0.0002，IL-6；0.049，肿瘤坏死因子α）。相反，自我报告的睡眠问题的变化与抑郁和焦虑的增加有关（p=0.001 和 p=0.01），辅助性 T 细胞 2（Th2）细胞因子 IL-5（p=0.027）和负调节细胞因子 IL-10（0.016）。
本研究表明，睡眠时间增加或睡眠问题减少与自我报告的情绪困扰减少以及促炎、Th2 和负调节细胞因子的衰减相关。我们的结果支持睡眠测量作为癌症生存中的有意义的生物行为变量。本研究还表明，睡眠研究人员应该意识到，方法的选择可能会影响与不同类别的免疫参数的一致性。
