Insomnia and Susceptibility to Depressive Symptoms and Fatigue in Diverse Breast Cancer Survivors

Haque, Reina; Hsu, Jin Wen; Avila, Chantal; Olmstead, Richard G.; Carroll, Judith; Irwin, Michael R.

doi:10.1089/jwh.2019.8135

Cited by 21 publications

(18 citation statements)

References 60 publications

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“…Sleep disturbance is prevalent in cancer patients and survivors, and understanding of its connection with the PNI could produce more effective interventions and improve QOL. Although a few groups have published extensive studies on stress and sleep in the context of cancer [ 2 , 68 – 71 , 72 – 74 ], few studies have examined the relationship of sleep, distress, and immunity in cancer patients [ 75 – 77 ] or cancer survivors [ 2 , 78 , 79 ], and none have been focused on cervical cancer patients or survivors.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Changes in Sleep: Associations with Shifts in Circulating Cytokines and Emotional Distress in a Cancer Survivor Population

et al. 2021

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Background Sleep disturbances are associated with numerous mood disorders. Similarly, anxiety and depression are associated with modulation of the psychoneuroimmune (PNI) axis. This study hypothesized that changes in both monitored and self-reported measures of sleep would relate to changes in circulating cytokine levels in an emotionally distressed population of cervical cancer survivors. Methods Biospecimens, patient-reported outcome (PRO) measures, and actigraphy were collected from cervical cancer survivors enrolled in a biobehavioral clinical trial. Longitudinal changes over a 4-month period were examined. Sleep time measured by actigraphy and PRO were analyzed for correlative changes with emotional distress and serum cytokines (n = 71). Results Longitudinal change in the actigraph measure of sleep time was inversely associated with changes in depression and anxiety (test for linear trend, p = 0.02 and p = 0.05 respectively), as well as acute-phase response/pro-inflammatory cytokines (test for linear trend, p = 0.003, interleukin (IL)-2; 0.022, IL-1β; 0.0002, IL-6; and 0.049, tumor necrosis factor α). Conversely, changes in self-reported sleep problems were related to an increase in depression and anxiety (p = 0.001 and p = 0.01 respectively), the T helper 2 (Th2) cytokine IL-5 (p = 0.027), and the counter-regulatory cytokine IL-10 (0.016). Conclusion This study showed that an increase in sleep time or decrease in sleep problems corresponded with a reduction in self-reported emotional distress and attenuation of pro-inflammatory, Th2, and counter-regulatory cytokines. Our results support sleep measurement as a meaningful biobehavioral variable in cancer survivorship. This study also indicates that sleep investigators should be aware that choice of methodology might influence concordance with different classes of immune parameters.

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Section: Discussionmentioning

confidence: 99%

Longitudinal Changes in Sleep: Associations with Shifts in Circulating Cytokines and Emotional Distress in a Cancer Survivor Population

et al. 2021

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“…In addition, some studies after treatment did report a correlation between sleep and fatigue [ 27 ], sleep–fatigue symptom clusters [ 28 ], or found sleep disturbance as a predictor of fatigue [ 29 ]. In adult oncology, an interrelationship between impaired sleep and fatigue in survivors using different methods and in diverse populations has been reported [ 30 , 31 , 32 ]; however, much remains unclear about the specific mechanisms of co-occurring insomnia and fatigue. Since studies in large samples in pediatric oncology are lacking, little information about sleep has been included within recommendations for the surveillance and treatment of cancer-related fatigue in pediatric oncology survivors [ 11 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

Insomnia Symptoms and Daytime Fatigue Co-Occurrence in Adolescent and Young Adult Childhood Cancer Patients in Follow-Up after Treatment: Prevalence and Associated Risk Factors

Peersmann

Grootenhuis

Straten

et al. 2022

Cancers

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Insomnia symptoms and daytime fatigue commonly occur in pediatric oncology, which significantly impact physical and psychosocial health. This study evaluated the prevalence of insomnia only, daytime fatigue only, the co-occurrence of insomnia–daytime fatigue symptoms, and associated risk factors. Childhood cancer patients (n = 565, 12–26 years old, ≥6 months after treatment) participated in a national, cross-sectional questionnaire study, measuring insomnia symptoms (ISI; Insomnia Severity Index) and daytime fatigue (single item). Prevalence rates of insomnia and/or daytime fatigue subgroups and ISI severity ranges were calculated. Multinomial regression models were applied to assess risk factors. Most patients reported no insomnia symptoms or daytime fatigue (61.8%). In the 38.2% of patients who had symptoms, 48.1% reported insomnia and daytime fatigue, 34.7% insomnia only, and 17.1% daytime fatigue only. Insomnia scores were higher in patients with insomnia–daytime fatigue compared to insomnia only (p < 0.001). Risk factors that emerged were: female sex and co-morbidities (all), shorter time after treatment and bedtime gaming (insomnia only), young adulthood (insomnia–fatigue/fatigue only), needing someone else to fall asleep and inconsistent wake times (both insomnia groups), lower educational level and consistent bedtimes (insomnia–fatigue). Insomnia symptoms and daytime fatigue are common and often co-occur. While current fatigue guidelines do not include insomnia symptoms, healthcare providers should inquire about insomnia as this potentially provides additional options for treatment and prevention.

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“…Sleep disorders, such as hypersomnia, short sleep duration, restless legs syndrome, parasomnia, sleep apnea and insomnia, experienced by breast cancer survivors were detected to be associated with decreased physical function and emotional states (including, depressive symptoms and distress), while low sleep quality was observed to be associated with greater levels of anxiety and depression (Cho and Hwang, 2021). However, "sparse population-based data exist about the contribution of insomnia symptoms to occurrence of depressive symptoms in breast cancer survivors" (Haque et al, 2020). A study by Ho et al, (2015) found a correlation between depression, fatigue and sleep quality in both premenopausal and postmenopausal women with breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Depression and Sleep Quality among Iranian Women with Breast Cancer

Shorofi

Nozari-Mirarkolaei

Arbon

et al. 2021

Asian Pac J Cancer Prev

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Background and purpose: Breast cancer causes many psychological disorders such as sleep disturbances and depression. The current study was, therefore, intended to describe sleep quality and depression and to identify the association between these two psychological disorders among Iranian women with breast cancer. Materials and methods: This descriptive, analytical, cross-sectional study was carried out on 120 women with non-metastatic unilateral breast cancer undergoing chemotherapy in an outpatient chemotherapy unit of a major public hospital. A total of 120 women who had already undergone mastectomy procedure were selected via convenience sampling method. Data were collected by the Beck Depression Inventory-II (BDI-II) and the Pittsburgh Sleep Quality Index (PSQI). Results: The mean score on BDI-II was 13.40 (± 6.51), and 30% (n=36) of women had mild depression and 14.2% (n=17) reported moderate-to-severe depression. The mean global score of sleep quality was found to be 6.48 (± 2.62). Furthermore, 50.8% (n=61) of women obtained a global PSQI score of 5. A positive correlation was found between depression scores and sleep quality scores (p=0.001, r= 0.48). Depression was also correlated with age, number of children, household gross income, sleep duration, sleep latency, and type of mastectomy procedure (p<0.05). Moreover, subjective sleep quality was correlated with number of chemotherapy sessions (p=0.001, r=-0.67) and daytime dysfunction (p=0.001, r=0.78). A positive correlation was also observed between sleep disturbances and habitual sleep efficiency (p = 0.02, r = 0.65). Conclusion:In conclusion, 30% of women had mild depression and 14.2% reported moderate-to-severe depression. The mean global score of sleep quality was found to be 6.48 (± 2.62), suggesting poor sleep quality. Furthermore, over half of the participants (50.8%) obtained a global PSQI score of 5 or greater which is indicative of poor sleep quality. A positive moderate correlation was also observed between depression and poor sleep quality.

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Insomnia and Susceptibility to Depressive Symptoms and Fatigue in Diverse Breast Cancer Survivors

Cited by 21 publications

References 60 publications

Longitudinal Changes in Sleep: Associations with Shifts in Circulating Cytokines and Emotional Distress in a Cancer Survivor Population

Longitudinal Changes in Sleep: Associations with Shifts in Circulating Cytokines and Emotional Distress in a Cancer Survivor Population

Insomnia Symptoms and Daytime Fatigue Co-Occurrence in Adolescent and Young Adult Childhood Cancer Patients in Follow-Up after Treatment: Prevalence and Associated Risk Factors

Depression and Sleep Quality among Iranian Women with Breast Cancer

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