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Breast Cancer Research and Treatment

, Volume 162, Issue 3, pp 581–589 | Cite as

Sleep duration and breast cancer prognosis: perspectives from the Women’s Healthy Eating and Living Study

  • Catherine R. Marinac
  • Sandahl H. Nelson
  • Shirley W. Flatt
  • Loki Natarajan
  • John P. Pierce
  • Ruth E. Patterson
Epidemiology

Abstract

Purpose

To examine whether baseline sleep duration or changes in sleep duration are associated with breast cancer prognosis among early-stage breast cancer survivors in the multi-center Women’s Healthy Eating and Living Study.

Methods

Data were collected from 1995 to 2010. Analysis included 3047 women. Sleep duration was self-reported at baseline and follow-up intervals. Cox proportional hazard models were used to investigate whether baseline sleep duration was associated with breast cancer recurrence, breast cancer-specific mortality, and all-cause mortality. Time-varying models investigated whether changes in sleep duration were associated with breast cancer prognosis.

Results

Compared to women who slept 7–8 h/night at baseline, sleeping ≥9 h/night was associated with a 48% increased risk of breast cancer recurrence (Hazard ratio [HR] 1.48, 95% Confidence interval [CI] 1.01, 2.00), a 52% increased risk of breast cancer-specific mortality (HR 1.52, 95% CI 1.09, 2.13), and a 43% greater risk of all-cause mortality (HR 1.43, 95% CI 1.07, 1.92). Time-varying models showed analogous increased risk in those who inconsistently slept ≥9 h/night (all P < 0.05), but not in those who consistently slept ≥9 h/night.

Conclusions

Consistent long or short sleep, which may reflect inter-individual variability in the need for sleep, does not appear to influence prognosis among early-stage breast cancer survivors.

Keywords

Sleep Longitudinal modeling Survival Survivorship 

Notes

Funding

Dr. Marinac was supported by the National Cancer Institute of the National Institutes of Health under award number F31 CA183125. Research support was also provided by funding from the National Cancer Institute under award numbers U54 CA155435, and R01 CA166293. 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

Conflict of interest

The authors have no financial or conflicts of interest to disclose.

Ethical Approval

All procedures performed involving human participants were in accordance with the ethical standards of the University of California, San Diego and 6 other clinical sites, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Catherine R. Marinac
    • 1
    • 2
    • 3
  • Sandahl H. Nelson
    • 3
    • 4
    • 5
  • Shirley W. Flatt
    • 4
  • Loki Natarajan
    • 3
    • 4
  • John P. Pierce
    • 3
    • 4
  • Ruth E. Patterson
    • 3
    • 4
  1. 1.Dana-Farber Cancer InstituteBostonUSA
  2. 2.Harvard TH Chan School of Public HealthBostonUSA
  3. 3.Department of Family Medicine and Public HealthUniversity of California, San DiegoLa JollaUSA
  4. 4.Moores Cancer Center University of California, San DiegoLa JollaUSA
  5. 5.Graduate School of Public HealthSan Diego State UniversitySan DiegoUSA

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