TY - JOUR
T1 - Patient characteristics associated with sleep disturbance in breast cancer survivors
AU - Ratcliff, Chelsea G.
AU - Zepeda, Stephanie G.
AU - Hall, Martica H.
AU - Tullos, Emily A.
AU - Fowler, Shaelyn
AU - Chaoul, Alejandro
AU - Spelman, Amy
AU - Arun, Banu
AU - Cohen, Lorenzo
N1 - Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/5
Y1 - 2021/5
N2 - Background: Disturbed sleep is common among breast cancer survivors. Identifying patients at risk for disturbed sleep and its sequelae will aid in improving screening and intervention strategies to improve sleep and cancer-related quality of life (QOL). Methods: Women with stages I–III breast cancer undergoing neoadjuvant or adjuvant chemotherapy (N = 415) reported subjectively assessed sleep quality (PSQI) and actigraphy-assessed wake after sleep onset (AAS-WASO), total sleep time (AAS-TST), and sleep efficiency (AAS-SE), sociodemographic, and clinical characteristics and completed questionnaires assessing physical and mental health QOL at study entry and 3, 6, 12, and 15 months later. Results: Being from a racially/ethnically underserved population was associated with poorer sleep in all indices (p’s <.04). Lower income was associated with poorer subjective sleep and greater AAS-WASO (p’s <.02). BMI was associated with lower AAS-SE (p <.001). Baseline subjective sleep complaints were positively associated with depression, fatigue, and health-related QOL and cancer-related symptoms across follow-up (p’s < 0.05). Baseline AAS-WASO was positively associated with anxiety and negatively associated with physical health-related QOL at the 3-month follow-up (p’s <.001). Baseline AAS-WASO and AAS-SE were associated with mental health-related QOL at the 6-month follow-up (p’s <.05). Conclusions: In keeping with previous health disparity research, racially/ethnically underserved populations, lower household income, and higher BMI were associated with increased risk for disturbed sleep. Sleep disturbance may have long-term effects on multiple aspects of QOL for women undergoing treatment for breast cancer. Results may inform strategies to identify patients at greatest risk for disturbed sleep and its sequelae.
AB - Background: Disturbed sleep is common among breast cancer survivors. Identifying patients at risk for disturbed sleep and its sequelae will aid in improving screening and intervention strategies to improve sleep and cancer-related quality of life (QOL). Methods: Women with stages I–III breast cancer undergoing neoadjuvant or adjuvant chemotherapy (N = 415) reported subjectively assessed sleep quality (PSQI) and actigraphy-assessed wake after sleep onset (AAS-WASO), total sleep time (AAS-TST), and sleep efficiency (AAS-SE), sociodemographic, and clinical characteristics and completed questionnaires assessing physical and mental health QOL at study entry and 3, 6, 12, and 15 months later. Results: Being from a racially/ethnically underserved population was associated with poorer sleep in all indices (p’s <.04). Lower income was associated with poorer subjective sleep and greater AAS-WASO (p’s <.02). BMI was associated with lower AAS-SE (p <.001). Baseline subjective sleep complaints were positively associated with depression, fatigue, and health-related QOL and cancer-related symptoms across follow-up (p’s < 0.05). Baseline AAS-WASO was positively associated with anxiety and negatively associated with physical health-related QOL at the 3-month follow-up (p’s <.001). Baseline AAS-WASO and AAS-SE were associated with mental health-related QOL at the 6-month follow-up (p’s <.05). Conclusions: In keeping with previous health disparity research, racially/ethnically underserved populations, lower household income, and higher BMI were associated with increased risk for disturbed sleep. Sleep disturbance may have long-term effects on multiple aspects of QOL for women undergoing treatment for breast cancer. Results may inform strategies to identify patients at greatest risk for disturbed sleep and its sequelae.
KW - Actigraphy
KW - Breast cancer
KW - Health disparities
KW - PSQI
KW - Quality of life
KW - Sleep
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U2 - 10.1007/s00520-020-05777-3
DO - 10.1007/s00520-020-05777-3
M3 - Article
C2 - 32964261
AN - SCOPUS:85091292322
SN - 0941-4355
VL - 29
SP - 2601
EP - 2611
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 5
ER -