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乳腺癌化疗期间采用强光疗法预防睡眠中断:一项II期随机对照试验

Preventing Sleep Disruption With Bright Light Therapy During Chemotherapy for Breast Cancer: A Phase II Randomized Controlled Trial.

作者信息

Rissling Michelle, Liu Lianqi, Youngstedt Shawn D, Trofimenko Vera, Natarajan Loki, Neikrug Ariel B, Jeste Neelum, Parker Barbara A, Ancoli-Israel Sonia

机构信息

Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.

Department of Medicine, University of California, San Diego, San Diego, CA, United States.

出版信息

Front Neurosci. 2022 Mar 9;16:815872. doi: 10.3389/fnins.2022.815872. eCollection 2022.

Abstract

PURPOSE

The goal of this study was to examine whether daily increased morning light exposure would maintain or improve sleep and the circadian pattern of relatively more activity in the day and less during the night in women undergoing chemotherapy for breast cancer.

PATIENTS AND METHODS

Participants were 39 women with newly diagnosed breast cancer, randomized to either 30-mins of daily morning bright white light (BWL) or dim red light (DRL). Sleep/wake was measured objectively for 72-h with wrist actigraphy and subjectively with the Pittsburgh Sleep Quality Index (PSQI) prior to and during chemotherapy cycles 1 and 4. The study was registered with the National Institutes of Health ClinicalTrials.gov (Clinical Trials number: NCT00478257).

RESULTS

Results from actigraphy suggested that compared to the DRL group, women in the BWL group had longer night-time sleep, fewer sleep disturbances during the night, and had fewer and shorter daytime naps at the end of cycle 4 of chemotherapy as well as exhibiting less activity at night and more activity during the day by the end of cycle 4. Results from PSQI indicated that components of sleep quality improved but daytime dysfunction deteriorated during cycle 4 treatment in the BWL group; meanwhile the DRL group used more sleep medications in the treatment weeks which might have led to the improved sleep quality during the recovery weeks of both cycles.

CONCLUSION

These results suggest that bright white light therapy administered every morning on awakening may protect women undergoing chemotherapy for breast cancer from nighttime sleep and daytime wake disruption. Randomized clinical trials in larger samples are needed to confirm these findings.

摘要

目的

本研究的目的是探讨每日增加早晨光照是否能维持或改善乳腺癌化疗女性的睡眠以及昼夜活动模式,即白天活动相对较多而夜间活动较少。

患者与方法

参与者为39名新诊断为乳腺癌的女性,随机分为每日早晨接受30分钟明亮白光(BWL)或昏暗红光(DRL)照射两组。在化疗第1周期和第4周期之前及期间,使用手腕活动记录仪客观测量睡眠/觉醒情况72小时,并使用匹兹堡睡眠质量指数(PSQI)进行主观评估。该研究已在美国国立卫生研究院ClinicalTrials.gov注册(临床试验编号:NCT00478257)。

结果

活动记录仪的结果表明,与DRL组相比,BWL组女性在化疗第4周期结束时夜间睡眠时间更长,夜间睡眠干扰更少,白天小睡次数和时长更少,并且在第4周期结束时夜间活动更少,白天活动更多。PSQI的结果表明,BWL组在第4周期治疗期间睡眠质量的组成部分有所改善,但白天功能障碍恶化;与此同时,DRL组在治疗周使用了更多的助眠药物,这可能导致两个周期恢复周期间睡眠质量得到改善。

结论

这些结果表明,每天早晨醒来时进行明亮白光疗法可能会保护接受乳腺癌化疗的女性免受夜间睡眠和白天觉醒干扰。需要更大样本的随机临床试验来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79da/8959343/9897ff66b404/fnins-16-815872-g001.jpg

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