Change in longitudinal trends in sleep quality and duration following breast cancer diagnosis: results from the Women’s Health Initiative

Beverly, Chloe; Naughton, Michelle J.; Pennell, Michael L.; Foraker, Randi E.; Young, Gregory S.; Hale, Lauren; Feliciano, Elizabeth M. Cespedes; Pan, Kathy; Crane, Tracy E.; Danhauer, Suzanne C.; Paskett, Electra D.

doi:10.1038/s41523-018-0065-7

Cited by 16 publications

(7 citation statements)

References 43 publications

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“…Overall, BC patients seem to have subtle but still present modifications of sleep architecture compared to HC. These results are in accordance with those of previous studies suggesting effects of cancer and/or diagnostic on sleep 32 , 33 . One may argue that the greater number of awakenings in patients could be driven by the effects of radiotherapy as most of our sample of patients was treated with radiotherapy following surgery.…”

Section: Discussionsupporting

confidence: 93%

Sleep macro- and microstructure in breast cancer survivors

Perrier

Duivon

Clochon

et al. 2022

Sci Rep

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Complaints of sleep disturbance are prevalent among breast cancer (BC) patients and are predictors of quality of life. Still, electrophysiological measures of sleep are missing in patients, which prevents from understanding the pathophysiological consequences of cancer and its past treatments. Using polysomnography, sleep can be investigated in terms of macro- (e.g. awakenings, sleep stages) and micro- (i.e. cortical activity) structure. We aimed to characterize sleep complaints, and macro- and microstructure in 33 BC survivors untreated by chemotherapy and that had finished radiotherapy since at least 6 months (i.e. out of the acute effects of radiotherapy) compared to 21 healthy controls (HC). Compared to HC, BC patients had a larger number of awakenings (p = 0.008); and lower Delta power (p < 0.001), related to sleep deepening and homeostasis; greater both Alpha (p = 0.002) and Beta power (p < 0.001), related to arousal during deep sleep; and lower Theta power (p = 0.004), related to emotion regulation during dream sleep. Here we show that patients have increased cortical activity related to arousal and lower activity related to sleep homeostasis compared to controls. These results give additional insights in sleep pathophysiology of BC survivors and suggest sleep homeostasis disruption in non-advanced stages of BC.

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Section: Discussionsupporting

confidence: 93%

Sleep macro- and microstructure in breast cancer survivors

Perrier

Duivon

Clochon

et al. 2022

Sci Rep

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“…Younger age has been associated with increased sleep disturbance [ 15 , 22 – 24 ], although other studies have found no association between age and sleep disturbance in patients with breast cancer [ 1 ]. Additionally, a large ( n = 12,098) longitudinal study found that breast cancer diagnosis was not significantly related to decreased sleep quality compared to pre-diagnosis, although sleep quality continued to decrease over time [ 25 ]. This would indicate that study participants would report poorer sleep quality as they aged.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with sleep disturbances in women undergoing treatment for early-stage breast cancer

Grayson

Sereika

Harpel

et al. 2021

Support Care Cancer

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Purpose The purpose of this study was to examine factors associated with sleep disturbance in women receiving adjuvant therapy for breast cancer. Methods This study employed a cross-sectional design using data collected at 3 months post-surgery from an ongoing longitudinal parent study. Participant data were divided into adjuvant treatment groups (chemotherapy, radiation, and aromatase inhibitors) and no adjuvant treatment groups. Symptoms were measured using patient self-report measures. Analysis of variance was used to assess between adjuvant treatment group differences in sleep disturbance. Regression analysis was performed to assess the relationship between sleep disturbance and other symptoms within adjuvant treatment groups. Results The sample included 156 women diagnosed with early-stage breast cancer. There were significant differences in levels of reported sleep disturbance between treatment groups (p = 0.049), with significantly higher levels of sleep disturbances in those receiving radiation compared to those receiving no adjuvant treatment (p = 0.038) and in those receiving chemotherapy and those receiving no adjuvant treatment (p = 0.027). Increased sleep disturbance was found to be a significant predictor for increased pain severity, nausea severity, anxiety, depressive symptoms, fatigue, decreased physical function, and decreased ability to participate in social roles and activities. Co-occurring symptoms with sleep disturbance differed between adjuvant treatment groups. Sleep disturbance was also associated with younger age (p = 0.008). Conclusions Patients undergoing chemotherapy or radiation for breast cancer report higher levels of sleep disturbance than those not receiving adjuvant therapy. Sleep disturbance is associated with other symptoms experienced by patients with cancer and thus requires continual assessment and future research into effective interventions.

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“…However, studies of the ISI in oncology samples have not yet focused specifically on cancer survivors after treatment completion. This is a significant gap in the literature, as the growing population of cancer survivors is known to have unique physical and psychological vulnerabilities, including high rates of insomnia, even many years after treatment . To address this, our study examined the internal consistency reliability and factor structure (ie, statistical approach to describing variability among variables) of the ISI (English version) in a sample of cancer survivors after treatment completion.…”

Section: Introductionmentioning

confidence: 99%

Psychometric properties of the Insomnia Severity Index in cancer survivors

2019

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Objective Insomnia is commonly associated with cancer treatment. Cancer treatments increase risk for numerous psychological and medical late effects, thus making cancer survivors psychologically and medically vulnerable. Prior research examined psychometric properties of the Insomnia Severity Index (ISI) with various populations, including the French version of the ISI, with participants undergoing active cancer treatment. However, no prior studies examined insomnia exclusively with cancer survivors, using the English version of the ISI. Methods This study examined internal consistency and factor structure of an English version of the ISI in 100 cancer survivors (Mage = 51.1; SD = 14.92). This final analytic sample was composed of participants from three different insomnia interventions. Survivors ranged from less than 1 year off treatment (17%) to 21+ years off treatment (6%), with most participants off treatment for 1 to 2 years (24%). Results The mean ISI score for the total sample was 16.69 (SD = 4.47), indicating clinical insomnia, with moderate severity. Principal Components Analysis (PCA) indicated two factors (five items loading on Factor I and two items loading on Factor II) and acceptable reliability (α = .73). Item‐total correlations ranged from .15 to .63. Conclusions Findings support the reliability of the ISI in cancer survivors. However, its factor structure warrants additional research with larger samples of cancer survivors. Results suggest inconsistency across participant responses and that ISI items may be functioning differently with this unique population of cancer survivors. Findings indicate that sleep maintenance problems are central to the experience of insomnia in our survivor sample.

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Change in longitudinal trends in sleep quality and duration following breast cancer diagnosis: results from the Women’s Health Initiative

Cited by 16 publications

References 43 publications

Sleep macro- and microstructure in breast cancer survivors

Sleep macro- and microstructure in breast cancer survivors

Factors associated with sleep disturbances in women undergoing treatment for early-stage breast cancer

Psychometric properties of the Insomnia Severity Index in cancer survivors

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