Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Cancer Epidemiol. 2023 Dec;87:102471. doi: 10.1016/j.canep.2023.102471. Epub 2023 Oct 12.
We investigated sleep disturbances among cancer survivors compared to similarly aged women without cancer history.
We identified 2067 women with a history of cancer other than breast or non-melanoma skin cancer at enrollment in the Sister Study, a US-wide cohort of women with a family history of breast cancer. Cancer survivors were matched with up to 5 cancer-free women (N = 9717) on age at enrollment. An index age (for covariate classification) was defined as the age at cancer diagnosis for survivors and the same age for their matched comparators. Sleep disturbances included duration, sleep medication usage, insomnia symptoms, long sleep-latency onset (≥30 min to fall asleep), frequent night awakenings (waking ≥3/night, ≥ 3 times/week), frequent napping (≥ 3 times/week), and a composite outcome of ≥ 1sleep disturbance. Multivariable linear regression (effect estimate, 95% confidence interval (CI)) and logistic regression (odds ratio, OR, 95% CI) were used for continuous and dichotomous outcomes, respectively.
At enrollment, cancer survivors were on average 13.8 years (range=0, 62) from diagnosis. After adjustment for age at enrollment and depression, diabetes, hypertension, and menopausal status prior to the index age, sleep disturbances were generally not more common among cancer survivors compared to those without cancer. However, among cancer survivors, those > 2 years from diagnosis were more likely to report ≥ 1 sleep disturbance (OR=1.44; 1.07, 1.93) compared to survivors 0-2 years from diagnosis.
Addressing sleep disturbances may improve well-being for cancer survivors.
我们调查了癌症幸存者与没有癌症病史的同龄女性相比的睡眠障碍情况。
我们在姐妹研究中确定了 2067 名患有除乳腺癌或非黑色素瘤皮肤癌以外的癌症的女性，这是一项针对有乳腺癌家族史的美国女性的队列研究。癌症幸存者与多达 5 名无癌症的女性（N=9717）按入组时的年龄进行匹配。将索引年龄（用于协变量分类）定义为幸存者的癌症诊断年龄和匹配对照者的相同年龄。睡眠障碍包括睡眠时间、睡眠药物使用、失眠症状、入睡潜伏期长（≥30 分钟入睡）、夜间频繁醒来（≥3/晚，≥3 次/周）、频繁小睡（≥3 次/周）以及≥1 种睡眠障碍的综合结果。多变量线性回归（效应估计值，95%置信区间（CI））和逻辑回归（比值比，OR，95%CI）分别用于连续和二分类结果。
在入组时，癌症幸存者从诊断到平均年龄为 13.8 岁（范围=0，62）。在调整入组时的年龄和抑郁、糖尿病、高血压以及指数年龄前的绝经状态后，与无癌症的女性相比，癌症幸存者的睡眠障碍通常并不更常见。然而，在癌症幸存者中，与诊断后 0-2 年的幸存者相比，诊断后>2 年的幸存者更有可能报告存在≥1 种睡眠障碍（OR=1.44；1.07，1.93）。
解决睡眠障碍问题可能会改善癌症幸存者的幸福感。
