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Sleep quality after initial chemotherapy for breast cancer

Supportive Care in Cancer volume 18, pages 679–689 (2010)Cite this article

Abstract

Goals of work

The goal of this study is to characterize sleep quality and quantity prior to and in the first three nights after initial chemotherapy for breast cancer.

Materials and methods

This study makes use of secondary analysis of data from two separate randomized clinical trials (RCT) of behavioral interventions to improve fatigue and sleep. Patients came from two comprehensive cancer centers, three clinical cancer centers, and 10 community clinics in five states. Participants were women with stage I–IIIA breast cancer treated with anthracycline and/or cyclophosphamide-based regimens.

Main results

Baseline data from each RCT were used in the analysis. Sixty-five percent of women self-reported poor sleep in the month preceding chemotherapy using the Pittsburgh Sleep Quality Index (PSQI) score >5. Three nights of actigraphy data indicated a wide range of sleep experience with an average of 10 awakenings and time (minutes) awake after sleep onset (WASO-M) averaging 61 min per night. The first night’s sleep was the worst. There was no statistically significant relationship between self-reported poor sleep and sleep measures obtained by actigraphy. Women with poor sleep at baseline (global PSQI >5) had significantly lower (p < 0.001) physical (PCS) and mental (MCS) health status. However, neither the PCS nor MCS was associated with any of the average actigraphy sleep parameters or night 1 parameters in the aggregated sample. Increasing age was also associated with poorer sleep.

Conclusions

A high percent of women with breast cancer begin chemotherapy with disturbed sleep and the initial nights after chemotherapy are characterized by sleep fragmentation that disrupts sleep maintenance. Interventions should focus on strategies to decrease the number and duration of night awakenings. Further research is needed to identify predictors of poor sleep during this time.

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Acknowledgement

We would like to thank Sangeeta Agrawal for her assistance in statistical analysis; Patricia A. Fischer, Jia-Wen Guo, and Bharathi Vedula for their assistance in actigraphy analysis; project staff, Tracey Newhall, Susan Brown & Karen Lindau; physicians, nurses, and support staff in participating clinics; and the women with breast cancer who participated in our studies.

Funding was provided by NINR 2 R01 NR04573 and NINR 5R01NR007762-05

Author information

Affiliations

  1. University of Utah College of Nursing, 10 South 2000 East, Salt Lake City, UT, 84112-5880, USA

    Susan L. Beck & Bob Wong

  2. College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA

    Ann M. Berger

  3. Fox Chase Cancer Center, 510 Township Line Road, Cheltenham, PA, 19012, USA

    Andrea M. Barsevick & Katie A. Stewart

  4. School of Health and Human Performance, University of North Carolina Greensboro, Greensboro, 126 HHP Building, PO Box 26170, Greensboro, NC, 27402-6170, USA

    William N. Dudley

Authors
  1. Susan L. Beck
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  2. Ann M. Berger
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  3. Andrea M. Barsevick
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  4. Bob Wong
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  5. Katie A. Stewart
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  6. William N. Dudley
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Corresponding author

Correspondence to Susan L. Beck.

Additional information

This work was performed at University of Utah College of Nursing and the Huntsman Cancer Institute in Salt Lake City, UT, USA; University of Nebraska Medical Center/Eppley Cancer Center, Oncology Hematology West PC, and the Southeastern Nebraska Hematology/Oncology Consultants in Omaha, NE, USA; and Fox Chase Cancer Center in Philadelphia, PA, USA, Helen F. Graham Cancer Center in Newark, DE, USA, and University of Cincinnati in Cincinnati, OH, USA

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Beck, S.L., Berger, A.M., Barsevick, A.M. et al. Sleep quality after initial chemotherapy for breast cancer. Support Care Cancer 18, 679–689 (2010). https://doi.org/10.1007/s00520-009-0662-y

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  • DOI: https://doi.org/10.1007/s00520-009-0662-y

Keywords

  • Sleep
  • Chemotherapy
  • Breast cancer
  • Actigraphy
  • Neoplasm
  • Function