Sleep medication use and risk of fractures in breast cancer survivors

Abstract

Purpose Sleep problems are more common in breast cancer survivors than those without a cancer history. Our goal was to examine the risk of fractures among breast cancers survivors who used prescription sleep aids. Methods We conducted a retrospective cohort study of 21,346 adult women diagnosed with stage 0–III breast cancer between 2009 and 2016 and followed them through 2017. We examined person-year rates of fractures by sleep medication use and calculated adjusted hazard ratios (HR) and 95% confidence intervals (CI) with Cox proportional hazards models using time-dependent variables for sleep medications and covariate medications (antidepressants, anti-anxiety medications, and bisphosphonates) adjusted for demographics, comorbidities, and tumor characteristics and cancer treatments. Results The sleep medication use was common (40%) in breast cancer survivors and was associated with a 33% increased risk of fractures (adjusted HR = 1.33, 95% CI: 1.20–1.49). Further, in a sensitivity analysis based on new use of sleep medication, the fracture risk was even stronger (adjusted HR = 1.44, 95% CI: 1.26–1.64). Conclusion Given the high use of sleep medications and the high risk of fractures in breast cancer survivors, this study suggests that non-pharmacologic management of sleep problems might be considered as alternative therapy.

Exploration of effects of galvanic vestibular stimulation on circadian rhythms and its associations with sleep and spatial memory in patients with breast cancer: The ICANSLEEP-2 protocol

“…These difficulties can be treated indirectly by targeting sleep disruption, either with medical drugs that may have negative effects or with APA and/or CBT, which may have a small effect on RAR or other circadian rhythm parameters, but not on sleep structure as measured with PSG, although CBT remains the first-line treatment for insomnia [ 45 , 46 , 49 ].…”

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Mi Sleep Coach Mobile App to Address Insomnia Symptoms Among Cancer Survivors: Single-Arm Feasibility Study

“…A recent national study found that approximately half of survivors of cancer with poor sleep reported using sleep medications [65]. This is of concern because the use of OTC or prescription sleep medications is associated with an increased risk of falls and fractures among older adults and survivors of cancer [66][67][68].…”

Study on the Effect of Positive Psychological Intervention Based on PERMA Model on Perioperative Patients with AIDS Complicated with Breast Cancer

“…Numerous studies have pointed out that psychological intervention can play an important and positive role in the maintenance of AIDS and mental health [11][12][13]. With the popularization of treatment, the proportion of malignant tumors in AIDS patients has changed greatly and the proportion of non-HIV-related malignant tumors such as breast cancer has increased significantly [14][15][16][17]. PERMA model is a happiness model proposed by Seligman, which consists of five elements such as positive emotion, input, interpersonal relationship, meaning, and achievement.…”