Breast Cancer Collaborative Registry informs understanding of factors predicting sleep quality
- 218 Downloads
Poor sleep quality is a common and persistent problem reported by women with breast cancer (BC). Empirical evidence identifies many risk factors for self-reported sleep deficiency, but inconsistencies limit translation to practice.
To increase understanding of risk factors predicting self-reported poor sleep quality in women with BC who completed the Breast Cancer Collaborative Registry (BCCR) questionnaire.
This cross-sectional study recruited women with a first diagnosis of BC (n = 1302) at five sites in Nebraska and South Dakota. Women completed the BCCR that includes numerous variables as well as the Pittsburgh Sleep Quality Index (PSQI) and SF36v2 (n = 1260). Descriptive statistics and non-parametric correlations were used to determine associations and create predictive models of sleep quality with BCCR variables and SF36v2 subscales.
Most women were white (93.7%) and married (71.5%); mean age was 60.1 (21–90) years. Poor sleep was self-reported by 53% of women. Seven variables were highly associated with sleep quality (p ≤ 0.001). The first model found younger age, lower physical activity, and higher fatigue were the strongest combined and independent variables predicting poor sleep quality (F = 23.0 (p < .001), R2 = 0.103). Participants self-reported lower health status on most SF36v2 subscales [Z = 44.9 (11.6) to 49.1 (10.1)]. A second model found that all subscales were predictors of poor sleep; vitality, mental health, bodily pain, and general health were the strongest predictors (F = 101.3 (p < .001), R2 = 0.26).
Results confirm previously identified risk factors and reveal inconsistencies in other variables. Clinicians need to routinely screen for the identified risk factors of self-reported poor sleep quality.
KeywordsSleep quality Sleep deficiency Symptoms Physical health Mental health Quality of life
We acknowledge Alice Kueh, MS, Oleg Shats, PhD, and Simon Sherman, PhD for their assistance on this project.
This project was supported by a pilot project award from the Fred & Pamela Buffett Cancer Center which is funded by a National Cancer Institute Cancer Center Support Grant under award number P30 CA036727. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Compliance with ethical standards
The Institutional Review Board (IRB) of the University of Nebraska Medical Center approved the study. At enrollment, patients provided informed consent for use of the data in clinical studies.
Conflict of interest
The authors declare they have no conflict of interest.
- 3.National Institute of Health (2011) National Institutes of Health Sleep Disorders Research Plan. https://www.nhlbi.nih.gov/health-pro/resources/sleep/nih-sleep-disorders-research-plan-2011
- 16.Mark S, Cataldo J, Dhruva A, Paul SM, Chen LM, Hammer MJ, Levine JD, Wright F, Melisko M, Lee K, Conley YP, Miaskowski C (2017) Modifiable and non-modifiable characteristics associated with sleep disturbance in oncology outpatients during chemotherapy. Support Care Cancer 25:2485–2494CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Visovsky C, Berger A, Hertzog M et al (2014) Breast cancer collaborative registry: comparison of physical and mental health and sleep in breast cancer survivors. JONS 5:29–38Google Scholar
- 24.Rogers LQ, Fogleman A, Trammell R, Hopkins-Price P, Spenner A, Vicari S, Rao K, Courneya KS, Hoelzer K, Robbs R, Verhulst S (2015) Inflammation and psychosocial factors mediate exercise effects on sleep quality in breast cancer survivors: pilot randomized controlled trial. Psycho-Oncol 24:302–310CrossRefGoogle Scholar
- 26.Dhruva A, Paul SM, Cooper BA, Lee K, West C, Aouizerat BE, Dunn LB, Swift PS, Wara W, Miaskowski C (2012) A longitudinal study of measures of objective and subjective sleep disturbance in patients with breast cancer before, during, and after radiation therapy. J Pain Symptom Manag 44:215–228CrossRefGoogle Scholar
- 27.Sherman S, Shats O, Fleissner E, Bascom G, Yiee K, Copur M, Crow K, Rooney J, Mateen Z, Ketcham MA, Feng J, Sherman A, Gleason M, Kinarsky L, Silva-Lopez E, Edney J, Reed E, Berger A, Cowan K (2011) Multicenter breast cancer collaborative registry. Cancer Inform 10:217–226PubMedPubMedCentralGoogle Scholar
- 28.Ware JE, Kosinski M, Dewey JE (2000) How to score version 2 of the SF-36® Health Survey. QualityMetric Incorporated, LincolnGoogle Scholar
- 30.Budhrani PH, Lengacher CA, Kip KE et al (2014) Minority breast cancer survivors: the association between race/ethnicity, objective sleep disturbances, and physical and psychological symptoms. Nurs Res Pract. https://doi.org/10.1155/2014/858403
- 31.Henneghan AM, Carter P, Stuifbergan A, Parmelee B, Kesler S (2018) Relationships between self-reported sleep quality components and cognitive functioning in breast cancer survivors up to 10 years following chemotherapy. Psycho-Oncol 27:1937–1943. https://doi.org/10.1002/pon.4745 CrossRefGoogle Scholar
- 44.Johnson JA, Rash JA, Campbell TS et al (2016) A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia (CBT-I) in cancer survivors. Sleep Med Reviews 27:20–28Google Scholar
- 45.NCCN (2018) NCCN guidelines cancer-related fatigue, version 2.2018. https://www.nccn.org/professionals/physician_gls/pdf/fatigue.pdf 2018. Accessed 08/02 2018
- 46.NCCN (2018) NCCN guidelines survivorship, version 1.2018. https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf. Accessed 08/02 2018