School of Nursing, Yale University, New Haven, USA.
Department of Nursing, Mayo Clinic, Rochester, USA.
J Cancer Surviv. 2024 Jun;18(3):828-835. doi: 10.1007/s11764-023-01330-3. Epub 2023 Jan 21.
Sleep disturbance is common among women with breast cancer and is associated with greater symptom distress and poorer outcomes. Yet, for the unique subgroup of young women with breast cancer (YWBC), there is limited information on sleep. To address the gap in our understanding of sleep health in YWBC, we explored their perspective on sleep quality, sleep changes over time, contributing factors, and any strategies used to promote sleep. As part of an explanatory sequential mixed method study, we recruited a sub-sample of 35 YWBC (≤ 50 years of age at the time of diagnosis) from the larger quantitative study phase. These participants were within the first 5 years since diagnosis and completed primary and systemic adjuvant therapy. We conducted virtual semi-structured interviews, transcribed them verbatim, and analyzed data with an interpretive description approach. YWBC experience difficulty falling asleep, waking up at night, and not feeling refreshed in the morning. They attributed interrupted sleep to vasomotor symptoms, anxiety/worry, ruminating thoughts, everyday life stressors, and discomfort. The sleep disturbance was most severe during and immediately after treatment but persisted across the 5 years of survivorship. The participants reported trying pharmacologic and non-pharmacologic strategies to improve the quantity and quality of their sleep. Future research would benefit from longitudinal designs to capture temporal changes in sleep and develop interventions to improve sleep health. Clinically, assessment of sleep health is indicated for YWBC related to the prevalence of disturbed sleep. IMPLICATIONS FOR CANCER SURVIVORS: Early access to sleep assessment and management, ideally before cancer treatment, would be beneficial for young breast cancer survivors. In addition, cancer treatment plans should include physical and psychological symptoms, especially those reported by women in this study: vasomotor symptoms, anxiety and worry, discomfort, and pain.
睡眠障碍在乳腺癌女性中很常见，与更大的症状困扰和更差的预后相关。然而，对于患有乳腺癌的年轻女性（YWBC）这一独特亚组，关于睡眠的信息有限。为了解决我们对 YWBC 睡眠健康理解的差距，我们探讨了她们对睡眠质量、随时间变化的睡眠变化、促成因素以及任何用于促进睡眠的策略的看法。作为解释性顺序混合方法研究的一部分，我们从更大的定量研究阶段招募了 35 名 YWBC（诊断时年龄≤50 岁）的子样本。这些参与者在诊断后的头 5 年内，完成了主要和系统辅助治疗。我们进行了虚拟半结构化访谈，逐字记录，并使用解释性描述方法分析数据。YWBC 入睡困难，夜间醒来，早上感觉不清醒。她们将睡眠中断归因于血管舒缩症状、焦虑/担忧、沉思、日常生活压力和不适。睡眠障碍在治疗期间和治疗后最为严重，但在 5 年的生存期间持续存在。参与者报告尝试了药物和非药物策略来提高睡眠质量和数量。未来的研究将受益于纵向设计，以捕捉睡眠的时间变化，并开发改善睡眠健康的干预措施。从临床角度来看，评估与睡眠障碍相关的 YWBC 的睡眠健康是必要的。对癌症幸存者的意义：对于年轻的乳腺癌幸存者，最好在癌症治疗前尽早进行睡眠评估和管理，这将是有益的。此外，癌症治疗计划应包括身体和心理症状，特别是本研究中报告的女性的症状：血管舒缩症状、焦虑和担忧、不适和疼痛。
