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

Abstract

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.

Sleep Disturbance and Related Factors in Patients with Nasopharyngeal Carcinoma and Their Family Caregivers Prior to the Initiation of Treatment

“…Although the current study did not identify any association between education and sleep disturbance in patients with NPC before treatment, a previous study reported that education was positively associated with an improvement in sleep quality among patients with poor sleep before breast cancer treatments 38 . Furthermore, less education was a significant predictor for poorer overall sleep in oncology patients at the initiation of chemotherapy 39 .…”

“…Finally, in this study, factors that predicted poor sleep quality of patients with NPC prior to the initiation of treatment only included demographic and personal characteristics and cancer-specific variables. However, a great number of previous studies have shown that pain, depression, anxiety, fatigue, and cognitive function were all associated with sleep quality in cancer patients 38 , 40 , 41 . Furthermore, these symptoms seldom occur in isolation.…”

Breast Cancer Collaborative Registry informs understanding of factors predicting sleep quality

“…Women who report poor sleep quality prior to chemotherapy often remain poor sleepers afterwards, and a percentage of good sleepers become poor sleepers, with 30-60% of patients affected [4]. Different BC treatments increase the risk of impaired sleep quality, thus contributing to the global disability associated with cancer treatments [5]. When poor sleep occurs with depression in patients with cancer, epidemiological observations link these symptoms to cancer morbidity and mortality risk [6].…”

“…When poor sleep occurs with depression in patients with cancer, epidemiological observations link these symptoms to cancer morbidity and mortality risk [6]. In addition, until there is routine screening, assessment, and treatment of sleep deficiency, an increasing number of BC survivors are likely to experience lower quality of life (QOL) [5,7].…”

Factors Associated With Poor Sleep in Older Women Diagnosed With Breast Cancer

“…About 75% of Americans report experiencing some type of sleep disturbance (Stanford Center for Sleep Sciences and Medicine, 2017), and 60% of older women diagnosed with breast cancer report poor sleep quality (Costa et al, 2014). Many individuals complain of problems sleeping even before receiving any cancer treatment (Fontes, Pereira, Costa, Gonçalves, & Lunet, 2017). Treatment for breast cancer often increases problems associated with poor sleep during and after cancer therapy (Costa et al, 2014).…”