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Relationship between sleep disturbance, symptoms, and alcohol use in breast cancer survivors attending Sydney Cancer Survivorship Clinic

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Abstract

Purpose

We sought to determine the association between ‘trouble sleeping’, alcohol intake, hot flashes, and quality of life (QOL) in early-stage breast cancer survivors attending the Sydney Cancer Survivorship Clinic (SCSC).

Methods

Survivors who had completed primary adjuvant treatment completed questionnaires assessing the following: symptoms, QOL (mean global score on FACT-G), and alcohol intake (drinks per day for past week), on the first visit to SCSC. Trouble sleeping and hot flashes were scored from 0 (no trouble at all) to 10 (worst I can imagine), with scores ≥ 4 classified as at least moderate and ≥ 7 severe.

Results

238 breast cancer survivors attended SCSC from September 2013 to May 2019, with data available for 227 (median age 53 years; 70% on endocrine therapy). Trouble sleeping was at least moderate in 54% and severe in 19%. 47% reported consuming alcohol (mean 4.9 drinks/week). Scores for trouble sleeping were no different between survivors reporting alcohol consumption and not (mean 4.13 vs. 3.6; p = 0.17). Survivors reporting at least moderate trouble sleeping (vs. less than moderate) were no more likely to drink alcohol (OR 1.74, 95% CI 0.96–3.14, p = 0.067) but had poorer mean QOL scores (69.1 vs. 78.3; p = 0.0006). Survivors reporting at least moderate hot flashes (vs. less than moderate) were more likely to report at least moderate trouble sleeping (OR 3.78, 95% CI 2.02–6.71, p < 0.0001) and had worse mean QOL scores (68 vs. 78; p = 0.001).

Conclusion

Trouble sleeping is common amongst breast cancer survivors and associated with hot flashes and poorer QOL, but not with self-reported alcohol consumption.

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References

  1. Savard J (2001) Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep. 24(5):583–590

    Article  CAS  Google Scholar 

  2. Savard J (2009) Prevalence, natural course, and risk factors of insomnia comorbid with cancer over a 2-month period. J Clin Oncol 27(31):5233–5239

    Article  Google Scholar 

  3. Carpenter J (2004) Sleep, fatigue, and depressive symptoms in breast cancer survivors and matched healthy women experiencing hot flashes. Oncol Nurs Forum 31(3):591–5598

    Article  Google Scholar 

  4. Engstrom CA (1999) Sleep alterations in cancer patients. Cancer Nurs 22(2):143–148

    Article  CAS  Google Scholar 

  5. Dahiya S, Ahluwalia MS, Walia HK (2013) Sleep disturbances in cancer patients: underrecognized and undertreated. Cleve Clin J Med 80(11):722–732

    Article  Google Scholar 

  6. Savard J, Morin CM (2001) Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 19(3):895–908

    Article  CAS  Google Scholar 

  7. Shapiro SL (2001) Quality of life and breast cancer: relationship to psychosocial variables. J Clin Psychol 57(4):501–519

    Article  CAS  Google Scholar 

  8. Hoffman AJ (2007) Relationships among pain, fatigue, insomnia, and gender in persons with lung cancer. Oncol Nurs Forum 34(4):785–792

    Article  Google Scholar 

  9. Fortner BV (2002) Sleep and quality of life in breast cancer patients. J Pain Symptom Manag 24(5):471–480

    Article  Google Scholar 

  10. MH K (2004) A women’s guide to sleep disorders. McGraw-Hill, New York

  11. Davidson JR (2002) Sleep disturbance in cancer patients. Soc Sci Med 54(9):1309–1321

    Article  Google Scholar 

  12. Aiello Bowles EJ (2012) Patient-reported discontinuation of endocrine therapy and related adverse effects among women with early-stage breast cancer. J Oncol Pract 8(6):e149–e157

    Article  Google Scholar 

  13. Stein MD, Friedmann PD (2005) Disturbed sleep and its relationship to alcohol use. Subst Abus 26(1):1–13

    Article  Google Scholar 

  14. Ebrahim IO (2013) Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res 37(4):539–549

    Article  CAS  Google Scholar 

  15. Brower KJ, Aldrich MS, Robinson EAR, Zucker RA, Greden JF (2001) Insomnia, self-medication, and relapse to alcoholism. Am J Psychiatry 158(3):399–404

    Article  CAS  Google Scholar 

  16. Cao Y et al (2015) Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies. BMJ. 351:h4238

    Article  CAS  Google Scholar 

  17. Scoccianti C (2016) European Code against Cancer 4th Edition: alcohol drinking and cancer. Cancer Epidemiol 45:181–188

    Article  Google Scholar 

  18. Kwan ML (2010) Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. J Clin Oncol 28(29):4410–4416

    Article  Google Scholar 

  19. Chlebowski RT, Aiello E, McTiernan A (2002) Weight loss in breast cancer patient management. J Clin Oncol 20(4):1128–1143

    Article  Google Scholar 

  20. Vardy JL (2017) Health status and needs of cancer survivors attending the Sydney Survivorship Centre clinics and programmes: a protocol for longitudinal evaluation of the centre's services. BMJ Open 7(5):e014803

    Article  Google Scholar 

  21. Stockler MR (2007) Effect of sertraline on symptoms and survival in patients with advanced cancer, but without major depression: a placebo-controlled double-blind randomised trial. Lancet Oncol 8(7):603–612

    Article  CAS  Google Scholar 

  22. Cella DF (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579

    Article  CAS  Google Scholar 

  23. Tuinman MA, Gazendam-Donofrio SM, Hoekstra-Weebers JE (2008) Screening and referral for psychosocial distress in oncologic practice: use of the Distress Thermometer. Cancer. 113(4):870–878

    Article  Google Scholar 

  24. Council, N.H.A.M.R. (2009) Australian Guidelines to Reduce Health Risks from Drinking Alcohol, Australian Government

  25. Adams, R., ; Appleton, Sarah; Taylor, Anne; McEvoy, Doug; Antic, Nick (2016) Report to the Sleep Health Foundation 2016 Sleep Health Survey of Australian Adults. Sleep Health Foundation

  26. Otte JL (2010) Prevalence, severity, and correlates of sleep-wake disturbances in long-term breast cancer survivors. J Pain Symptom Manag 39(3):535–547

    Article  Google Scholar 

  27. Leysen L (2019) Prevalence and risk factors of sleep disturbances in breast cancersurvivors: systematic review and meta-analyses. Support Care Cancer 27(12):4401–4433

    Article  Google Scholar 

  28. Smagula SF (2016) Risk factors for sleep disturbances in older adults: evidence from prospective studies. Sleep Med Rev 25:21–30

    Article  Google Scholar 

  29. Desai K (2013) Prevalence and risk factors for insomnia among breast cancer patients on aromatase inhibitors. Support Care Cancer 21(1):43–51

    Article  Google Scholar 

  30. Nguyen J (2011) A literature review of symptom clusters in patients with breast cancer. Expert Rev Pharmacoecon Outcomes Res 11(5):533–539

    Article  Google Scholar 

  31. Lee L (2020) Symptom clusters in breast cancer survivors: a latent class profile analysis. Oncol Nurs Forum 47(1):89–100

    Article  Google Scholar 

  32. Kwekkeboom KL (2016) Cancer Symptom Cluster Management. Semin Oncol Nurs 32(4):373–382

    Article  Google Scholar 

  33. Welfare, A.I.o.H.a (2017) National Drug Stategy Household Survey 2016: detailed findings. Australian Government

  34. Bell RJ (2012) Changes in patterns of use of cigarettes and alcohol in women after a first diagnosis of invasive breast cancer: a cohort study of women from Victoria, Australia. Support Care Cancer 20(4):783–789

    Article  Google Scholar 

  35. Ford DE, Kamerow DB (1989) Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? Jama. 262(11):1479–1484

    Article  CAS  Google Scholar 

  36. Moore TA, Berger AM, Dizona P (2011) Sleep aid use during and following breast cancer adjuvant chemotherapy. Psychooncology. 20(3):321–325

    Article  Google Scholar 

  37. Tan SY, Turner J, Kerin-Ayres K, Butler S, Deguchi C, Khatri S, Mo C, Warby A, Cunningham I, Malalasekera A, Dhillon HM, Vardy JL (2019) Health concerns of cancer survivors after primary anti-cancer treatment. Support Care Cancer 27(10):3739–3747

    Article  CAS  Google Scholar 

  38. Chen D, Yin Z, Fang B (2018) Measurements and status of sleep quality in patients with cancers. Support Care Cancer 26(2):405–414

    Article  Google Scholar 

  39. Howell D (2014) Sleep disturbance in adults with cancer: a systematic review of evidence for best practices in assessment and management for clinical practice. Ann Oncol 25(4):791–800

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Concord Cancer Centre, Concord Repatriation General Hospital, Concord, New South Wales, Australia

    Emma-Kate Carson, Janette L. Vardy & Belinda E. Kiely

  2. Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia

    Emma-Kate Carson & Janette L. Vardy

  3. Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, New South Wales, Australia

    Janette L. Vardy & Haryana M. Dhillon

  4. Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, New South Wales, Australia

    Haryana M. Dhillon

  5. NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia

    Christopher Brown & Belinda E. Kiely

Authors
  1. Emma-Kate Carson
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  2. Janette L. Vardy
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  3. Haryana M. Dhillon
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  4. Christopher Brown
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  5. Belinda E. Kiely
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Contributions

EC: study concept, design, data analysis, and writing of the manuscript. JV, HD, and BK: study concept and design. CB: data analysis. All authors reviewed final manuscript.

Corresponding author

Correspondence to Emma-Kate Carson.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards (Institutional Human Research Ethics Committee protocol number HREC/14/CRGH/23).

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

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Informed consent to have de-identified data published was obtained from all individual participants included in the study.

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The authors declare that they have no conflicts of interest.

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Carson, EK., Vardy, J.L., Dhillon, H.M. et al. Relationship between sleep disturbance, symptoms, and alcohol use in breast cancer survivors attending Sydney Cancer Survivorship Clinic. Support Care Cancer 29, 6233–6242 (2021). https://doi.org/10.1007/s00520-021-06176-y

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  • DOI: https://doi.org/10.1007/s00520-021-06176-y

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