Journal
PSYCHO-ONCOLOGY
Volume 23, Issue 11, Pages 1220-1228Publisher
WILEY
DOI: 10.1002/pon.3525
Keywords
chemotherapy; breast cancer; fatigue; sleep; ecological momentary assessment; QOL
Funding
- NCI NIH HHS [R25 CA057730, P30 CA016672, R25T CA57730,] Funding Source: Medline
- NIMH NIH HHS [R21 MH062031, 5R21MH062031-02] Funding Source: Medline
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ObjectiveThis study examined the association of sleep before and during a chemotherapy (CT) cycle for breast cancer with symptoms and mood during a CT cycle. MethodsTwenty women undergoing CT for breast cancer completed the Pittsburgh Sleep Quality Index (PSQI) 1h prior to a CT infusion. For 3weeks following infusion, participants estimated sleep efficiency, minutes to sleep (sleep latency), number of nocturnal awakenings (sleep fragmentation (SF)), and sleep quality (SQ) each morning and rated symptoms (nausea, fatigue, numbness, and difficulty thinking) and mood three times daily (morning, afternoon, and evening) via ecological momentary assessments using automated handheld computers. ResultsThe results showed that disturbed sleep (PSQI score > 5) prior to CT infusion was associated with greater fatigue, and more negative and anxious mood throughout the 3-week CT cycle, and good pre-CT infusion sleep (PSQI score<5) buffered anxious mood in the first days following infusion. Time-lagged analyses controlling for mood/symptom ratings reported the previous evening revealed that longer sleep latency and greater SF were associated with greater daytime fatigue; poorer SQ and greater SF were antecedents of worse morning negative mood, and greater SF was associated with feeling more passive and drowsy. No evening symptom or mood ratings were related to subsequent SQ. ConclusionsThese findings suggest that disturbed sleep before and after a CT infusion exacerbates fatigue, and negative, anxious, and drowsy mood during a CT cycle. Reducing sleep disturbance may be an important way to improve quality of life during CT. Copyright (c) 2014 John Wiley & Sons, Ltd.
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