Li Xiaoying, Gao Chang, Wei Yifan, Wen Zhaoyan, Li Xinyu, Liu Fanghua, Gong Tingting, Yan Shi, Qin Xue, Gao Song, Zhao Yuhong, Wu Qijun
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang 110004, China.
J Clin Med. 2022 Nov 23;11(23):6914. doi: 10.3390/jcm11236914.
Objective: To explore if pre-diagnosis sleep status is associated with overall survival (OS) of ovarian cancer (OC). Methods: This is a prospective cohort study of 853 OC patients newly diagnosed between 2015 and 2020. Sleep status was measured by the Pittsburgh Sleep Quality Index (PSQI). Vital status of patients was obtained through active follow-up and linkage to medical records and cancer registry. The Cox proportional hazards regression model was utilized to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for aforementioned associations. Results: During the follow-up period (median: 37.57 months, interquartile: 25.00 to 50.17 months), 123 (18.39%) OC patients died. The HR (95%CI) for OS of OC was 2.13 (1.42−3.18) for sleeping after 22:00, compared with sleeping before 22:00; 2.43 (1.64−3.62) for poor sleep quality, compared to good sleep quality; 2.26 (1.37−3.72) for late bed-early rise and 1.93 (1.09−3.42) for late bed-late rise, compared with early bed-early rise; 0.40 (0.24−0.67) for night sleep duration of ≥7.5 h/day, compared with 7−7.5 h/day; 0.53 (0.29−0.98) for total sleep duration of ≥8 h/day, compared with 7.5−8 h/day. Further, the interaction effects were significant between residual lesions and wake-up time, night bedtime, sleep pattern, and between total sleep duration and menopausal status, parity. Additionally, there was a significant curvilinear association between PSQI score and OS (p nonlinear <0.05). Conclusions: Pre-diagnosis longer total and night sleep duration were associated with better OS, whereas later sleeping time, poor sleep quality, and bad sleep patterns were associated with poor OS among OC survivors.
探讨卵巢癌（OC）诊断前的睡眠状况与总生存期（OS）之间是否存在关联。方法：这是一项对2015年至2020年间新诊断的853例OC患者进行的前瞻性队列研究。睡眠状况通过匹兹堡睡眠质量指数（PSQI）进行测量。通过主动随访以及与医疗记录和癌症登记处的关联来获取患者的生存状态。采用Cox比例风险回归模型计算上述关联的风险比（HRs）和95%置信区间（CIs）。结果：在随访期间（中位数：37.57个月，四分位间距：25.00至50.17个月），123例（18.39%）OC患者死亡。与22:00前入睡相比，22:00后入睡的OC患者OS的HR（95%CI）为2.13（1.42 - 3.18）；与睡眠质量良好相比，睡眠质量差的HR为2.43（1.64 - 3.62）；与早睡早起相比，晚睡早起的HR为2.26（1.37 - 3.72），晚睡晚起的HR为1.93（1.09 - 3.42）；与每天夜间睡眠时间7 - 7.5小时相比，每天夜间睡眠时间≥7.5小时的HR为0.40（0.24 - 0.67）；与每天总睡眠时间7.5 - 8小时相比，每天总睡眠时间≥8小时的HR为0.53（0.29 - 0.98）。此外，残留病灶与起床时间、夜间就寝时间、睡眠模式之间，以及总睡眠时间与绝经状态、产次之间的交互作用显著。另外，PSQI评分与OS之间存在显著的曲线关联（p非线性<0.05）。结论：诊断前较长的总睡眠时间和夜间睡眠时间与较好的OS相关，而较晚的睡眠时间、较差的睡眠质量和不良的睡眠模式与OC幸存者较差的OS相关。
