The relative importance of specific risk factors for insomnia in women treated for early‐stage breast cancer

Bardwell, Wayne A.; Profant, Judith; Casden, Danielle R.; Dimsdale, Joel E.; Ancoli‐Israel, Sonia; Natarajan, Loki; Rock, Cheryl L.; Pierce, John P.

doi:10.1002/pon.1192

Cited by 117 publications

(112 citation statements)

References 84 publications

(114 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Though the prevalence ranges vary depending on the study characteristics, cancer survivors have consistently reported higher rates of sleep problems compared than the general population (Savard and Morin, 2001;Schultz et al, 2005;Bardwell et al, 2008;Mulrooney et al, 2008;Savard et al, 2011;Zhou and Recklitis, 2014), which parallel with our findings. Notwithstanding the limits of knowledge on the exact mechanism across the cancer trajectory, cancer-related sleep problems covering difficulties initiating or maintaining sleep, dissatisfaction with sleep quality, and/or short sleep duration appear to begin with cancer diagnosis, inducing emotional challenges (i.e., anxiety and distress), and are easily exacerbated during cancer treatments such as chemotherapy, which continue through cancer survivorship (Palesh et al, 2012;Garland et al, 2014).…”

Section: Discussionsupporting

confidence: 82%

“…Other cancer-related somatic symptoms (i.e., fatigue, nausea, and diarrhea), psychological distress, and depression can also interrupt the sleeping patterns in cancer patients (Garland et al, 2014). Furthermore, emerging evidence has indicated that these negative consequences accompanied with cancer diagnosis may persist during long-term survivorship: many of cancer survivors have reported symptoms of insomnia and undergone sleep disturbance more likely than the general population (Savard and Morin, 2001;Schultz et al, 2005;Bardwell et al, 2008;Mulrooney et al, 2008;Savard et al, 2011;Zhou and Recklitis, 2014), which can progress to an increased risk for morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Short Sleep Duration and Its Correlates among Cancer Survivors in Korea: the Korea National Health and Nutrition Examination Surveys

Yoon

Yang

Song

et al. 2015

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: Though a large proportion of cancer survivors are assumed to be commonly affected by sleep disturbance, few studies have focused on short sleep problems and its correlates among Korean cancer survivors. The purpose of this study was to evaluate the prevalence of short sleep in adult cancer survivors from a nationwide population-based sample and to identify risk factors for short sleep duration. Materials and Methods: Based on the fourth and fifth Korea National Health and Nutrition Examination Surveys (2007-2012), 1,045 cancer survivors and 33,929 non-cancer controls were analyzed. The prevalence of short sleep was compared between these two groups. Associations between short sleep and its correlates were evaluated using multiple logistic regression among cancer survivors: odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated after adjusting for sociodemographic factors, lifestyle factors, psychological conditions, and cancer-related factors. Results: About 8.1% of cancer survivors slept for less than 5 hours per day (6.2% men and 9.3% women), whereas this was the case for only 3.7% of non-cancer controls. Cancer survivors who had the lowest household income level showed a significantly higher likelihood for short sleep (adjusted OR 2.82, 95%CI 1.06-7.54). Self-reported poor health and depressive symptoms were found to be associated with significantly increased likelihood for short sleep in cancer survivors (adjusted OR 3.60, 95%CI 1.40-9.26 and adjusted OR 2.00, 95%CI 1.17-3.42). Gastric cancer survivors had a 3.97-fold increased risk for short sleep (95%CI 1.60-9.90). Conclusions: The prevalence of short sleep occurs at a high rate among the Korean cancer survivors, which may indicate a poorer quality of life and a higher risk of future complications in survivorship. Targeted interventions that can assist cancer survivors to cope with sleep disturbances as well as ensuring psychological stability are warranted to reduce the latent disease burden.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Short Sleep Duration and Its Correlates among Cancer Survivors in Korea: the Korea National Health and Nutrition Examination Surveys

Yoon

Yang

Song

et al. 2015

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

show abstract

“…The relationship between education and sleep disturbance in breast cancer patients has not been consistent across studies [34,39,40]. Nevertheless, our findings may reflect the fact that more educated women may have better knowledge regarding breast cancer prognosis and treatment-related disability that can contribute to minimize the physical and psychological impact of cancer diagnosis and cancer treatment on sleep quality.…”

Section: Discussioncontrasting

confidence: 49%

“…Finally, through a systematic review, Brown et al confirm the association of fatigue with depression and anxiety but emphasize the need of longitudinal studies to better delineate its directionality [33]. Previous results described a tendency for higher levels of sleep disturbance in women submitted to radiotherapy when compared to those not submitted to this type of treatment, though results were not statistically significant [26,27,34]. We found a nearly fourfold higher risk of poor sleep quality among women submitted to the highest doses of radiotherapy; the impact of physical side effects of radiation, such as skin reactions and pain, which have been demonstrated to increase with the dose administered [35], could be precipitating factors for sleep disturbances in those with good sleep quality prior to treatment.…”

Section: Discussionmentioning

confidence: 86%

The impact of breast cancer treatments on sleep quality 1 year after cancer diagnosis

Fontes

Pereira

Costa

et al. 2017

Support Care Cancer

View full text Add to dashboard Cite

Purpose The increasing number of women living longer with potential side effects of breast cancer treatment highlights the need of a comprehensive assessment of its burden. Therefore, we aimed to quantify the relation between different breast cancer treatments and sleep quality 1 year after diagnosis. Methods A cohort of 502 newly diagnosed breast cancer patients was prospectively followed. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI), at baseline and at the 1-year follow-up. Odds ratios (OR) were computed to quantify the association between patient characteristics and poor sleep quality (PSQI score >5) at baseline, and relative risks (RR) were computed for the association between treatments and the occurrence of poor sleep quality at 1 year. Results A total of 60.2% of the patients had poor sleep quality before breast cancer treatments, especially those with anxiety [OR = 2.86, 95% confidence interval (95%CI) 1.92 to 4.27] or depression (OR = 5.25, 95%CI 2.01 to 13.67). Radiotherapy increased the risk of poor sleep quality at 1 year (RR = 3.71, 95%CI 1.15 to 11.96, for a cumulative dose >50 Gy) and there was a tendency for a higher risk in those submitted to chemotherapy, although not statistically significant.Conclusions Our study shows that sleep disturbances are frequent before cancer treatment and confirms their cooccurrence with other medical conditions, such as anxiety and depression. Different breast cancer treatments increase the risk of impaired sleep quality, therefore contributing to the global disability associated with cancer treatments.

show abstract

“…59 Rather, worse physical health, less exercise, and more depressive symptoms were the risk factors most strongly linked with fatigue in these women who had completed initial treatment within the previous four years. 59 Thus, the evidence linking mood disturbance and cancer-related fatigue is variable. It is difficult to tease out the effects of the medical illness versus those of mood symptoms on fatigue in the chronically medically ill. 24,54 Nonetheless, the fact that four out of five breast cancer patients with cancer-related fatigue do not experience a concurrent major depressive disorder suggests that mood and fatigue in cancer are overlapping but far from fully redundant concepts.…”

Section: Depressionmentioning

confidence: 99%

Breast Cancer and Fatigue

Bardwell

Ancoli‐Israel

2008

Sleep Medicine Clinics

Self Cite

View full text Add to dashboard Cite

SynopsisFatigue is a common and disabling symptom in breast cancer patients and survivors. A rather nebulous concept, fatigue overlaps with sleepiness and depressed mood. In this chapter, we cover methods for assessing fatigue; describe the occurrence of fatigue before, during and after initial treatment; present possible underlying mechanisms of fatigue; and, enumerate approaches to its treatment. KeywordsFatigue; breast cancer; sleep; mood; fatigue assessment Fatigue is a common and frequently disabling symptom in cancer patients and cancer survivors. 1,2 Fatigue is also often a presenting symptom at cancer diagnosis. 3-5 Cancer fatigue differs from other manifestations of fatigue in that it is generally not alleviated by sleep or rest, is typically of greater duration and severity, is often associated with high levels of distress, and is disproportionate to the level of exertion. 6-11 Cancer-related fatigue often co-occurs with other troublesome symptoms such as pain, sleep disturbance, and depression. 12-14 Thus, the impact of cancer fatigue on health-related quality of life can be substantial, reducing the patient's engagement in work, personal and social activity. 2,15-17 Some studies have reported that fatigue in cancer patients has a greater negative impact on quality of life than all other symptoms, including nausea, pain and depression. 2,18 Treatment of cancer-related fatigue has been recently identified as a priority by the National Institutes of Health. 19 Specific to breast cancer, fatigue is reported by a substantial majority of patients during their initial treatment (surgery, radiation, and/or chemotherapy). In addition, although estimates vary widely, approximately 33% of individuals with breast cancer report persistent fatigue up to ten years into survivorship. 6,20,21 Fatigue is a rather nebulous symptom; hence, numerous definitions of this construct are found in the literature. 6,22 Complicating this situation is the fact that breast cancer patients and survivors commonly complain of both sleepiness and fatigue. 23 These terms are often used interchangeably, and both have been linked to decrements in various aspects of health-related Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. As is the case with pain, fatigue is a complaint that is almost always evaluated using self-report scales. 6,24 Therefore, by default, fatigue is ultimately defined by the instruments employed for its measurement. In the next section we provide an overview of several types of scales for assessing fatigue. NIH Public Access Assessment of FatigueThere are numerous self-r...

show abstract

The relative importance of specific risk factors for insomnia in women treated for early‐stage breast cancer

Abstract: Background-Many individual risk factors for insomnia have been identified for women with a history of breast cancer. We assessed the relative importance of a wide range of risk factors for insomnia in this population.

Cited by 117 publications

References 84 publications

Short Sleep Duration and Its Correlates among Cancer Survivors in Korea: the Korea National Health and Nutrition Examination Surveys

Short Sleep Duration and Its Correlates among Cancer Survivors in Korea: the Korea National Health and Nutrition Examination Surveys

The impact of breast cancer treatments on sleep quality 1 year after cancer diagnosis

Breast Cancer and Fatigue

Contact Info

Product

Resources

About