Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada.
Sleep. 2021 Oct 11;44(10). doi: 10.1093/sleep/zsab111.
Poor sleep quality affects nearly one-third of breast cancer survivors and is associated with insulin resistance. The purpose of this secondary analysis was to examine the effects of a 16-week exercise intervention on patient-reported sleep quality among breast cancer survivors and assess whether changes in patient-reported sleep quality were associated with cardiometabolic biomarkers. We explored Hispanic ethnicity as a moderator of the effects of exercise on patient-reported sleep quality.
Breast cancer survivors who were overweight or obese were randomized to exercise (n = 50) or usual care (n = 50). The 16-week intervention included aerobic and resistance exercise. Patient-reported sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and biomarkers of cardiometabolic health were assessed at baseline and post-intervention. Within- and between-group differences were assessed using general linear models repeated-measures analyses of variance and mixed-model repeated-measure analysis, respectively. Associations between changes in PSQI and cardiometabolic biomarkers were computed using Pearson correlations. Linear mixed-models were used to evaluate effect modification by ethnicity.
Participants were 52 ± 10.4 years old, and over half were of Hispanic ethnicity. As compared to usual care, PSQI global scores improved significantly in the exercise group (mean between-group difference -2.2; 95% CI -3.2 to -0.6). Change in PSQI was inversely associated with changes in all cardiometabolic biomarkers (p < 0.01) among the exercise group. Ethnicity was found to moderate the effects of exercise training on global sleep quality (p < 0.001).
An aerobic and resistance exercise intervention effectively improved patient-reported sleep quality in breast cancer survivors. Hispanic ethnicity as a moderator showed greater improvement in patient-reported sleep indicating Hispanic versus non-Hispanic breast cancer survivors may derive larger sleep benefits.
NCT01140282.
睡眠质量差影响近三分之一的乳腺癌幸存者，并与胰岛素抵抗有关。本二次分析的目的是研究 16 周运动干预对乳腺癌幸存者患者报告睡眠质量的影响，并评估患者报告睡眠质量的变化是否与心脏代谢生物标志物相关。我们探讨了西班牙裔种族对运动对患者报告睡眠质量影响的调节作用。
超重或肥胖的乳腺癌幸存者被随机分为运动组（n = 50）或常规护理组（n = 50）。16 周的干预包括有氧运动和抗阻运动。在基线和干预后评估患者报告的睡眠质量（匹兹堡睡眠质量指数[PSQI]）和心脏代谢健康的生物标志物。使用一般线性模型重复测量方差分析和混合模型重复测量分析分别评估组内和组间差异。使用 Pearson 相关分析计算 PSQI 变化与心脏代谢生物标志物之间的相关性。使用线性混合模型评估种族的效应修饰作用。
参与者的年龄为 52 ± 10.4 岁，超过一半是西班牙裔。与常规护理相比，运动组 PSQI 总分显著改善（组间平均差异-2.2；95%CI-3.2 至-0.6）。运动组 PSQI 的变化与所有心脏代谢生物标志物的变化呈负相关（p < 0.01）。研究发现，种族是运动训练对整体睡眠质量影响的调节因素（p < 0.001）。
有氧运动和抗阻运动干预有效地改善了乳腺癌幸存者的患者报告睡眠质量。作为调节因素的西班牙裔种族表明，患者报告的睡眠质量有更大的改善，表明西班牙裔与非西班牙裔乳腺癌幸存者可能从睡眠中获得更大的益处。
NCT01140282。
