Perrier Joy, Galin Melvin, Denise Pierre, Giffard Bénédicte, Quarck Gaëlle
Neuropsychologie et Imagerie de la Mémoire Humaine U1077, EPHE, INSERM, CHU de Caen, GIP Cyceron, PSL Université, Normandie Univ, Université de Caen Normandie, 14000 Caen, France.
COMETE U1075, INSERM, CYCERON, CHU de Caen, Normandie Univ, Université de Caen Normandie, 14000 Caen, France.
Cancers (Basel). 2023 May 25;15(11):2904. doi: 10.3390/cancers15112904.
Insomnia symptoms are common among patients with breast cancer (BC; 20-70%) and are predictors of cancer progression and quality of life. Studies have highlighted sleep structure modifications, including increased awakenings and reduced sleep efficiency and total sleep time. Such modifications may result from circadian rhythm alterations consistently reported in this pathology and known as carcinogenic factors, including lower melatonin levels, a flattened diurnal cortisol pattern, and lower rest-activity rhythm amplitude and robustness. Cognitive behavioral therapy and physical activity are the most commonly used non-pharmacological interventions to counter insomnia difficulties in patients with BC. However, their effects on sleep structure remain unclear. Moreover, such approaches may be difficult to implement shortly after chemotherapy. Innovatively, vestibular stimulation would be particularly suited to tackling insomnia symptoms. Indeed, recent reports have shown that vestibular stimulation could resynchronize circadian rhythms and improve deep sleep in healthy volunteers. Moreover, vestibular dysfunction has been reported following chemotherapy. This perspective paper aims to support the evidence of using galvanic vestibular stimulation to resynchronize circadian rhythms and reduce insomnia symptoms in patients with BC, with beneficial effects on quality of life and, potentially, survival.
失眠症状在乳腺癌（BC）患者中很常见（发生率为20%-70%），并且是癌症进展和生活质量的预测指标。研究强调了睡眠结构的改变，包括觉醒增加、睡眠效率降低和总睡眠时间减少。这种改变可能源于在这种病理状态下一直报道的昼夜节律改变，这些改变被认为是致癌因素，包括褪黑素水平降低、昼夜皮质醇模式变平以及休息-活动节律幅度和稳定性降低。认知行为疗法和体育活动是治疗BC患者失眠问题最常用的非药物干预措施。然而，它们对睡眠结构的影响仍不清楚。此外，在化疗后不久可能难以实施这些方法。创新的是，前庭刺激可能特别适合解决失眠症状。事实上，最近的报告表明，前庭刺激可以使健康志愿者的昼夜节律重新同步并改善深度睡眠。此外，化疗后已报告存在前庭功能障碍。这篇观点论文旨在支持使用电前庭刺激使BC患者的昼夜节律重新同步并减轻失眠症状的证据，这对生活质量以及可能对生存率有有益影响。
