Sleep Quality and Related Factors in Patients with Breast Cancer: A Cross-Sectional Study in Taiwan

Abstract

Yi-Ping Weng,1,2 Rei-Mei Hong,2 Vincent Chin-Hung Chen,3,4 Chia-Jui Tsai,5,6 Dah-Cherng Yeh,7 Yu-Hung Fang8 1Department of Nursing, Chia-Yi Chang Gung Memorial Hospital, Chiayi branch, Puzi City, Chiayi County, Taiwan, R.O.C; 2Department of Nursing, Chia-Yi Chang Gung University of Science and Technology, Chiayi branch, Puzi City, Chiayi County, Taiwan, R.O.C; 3Department of Psychiatry, Chang Gung Medical Foundation, Chang Gung Memorial Hospital, Chiayi branch, Puzi City, Chiayi County, Taiwan, R.O.C; 4School of Medicine, Chang Gung University, Taoyuan City, Taiwan, R.O.C; 5Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C; 6Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, R.O.C; 7Breast Medical Center, Cheng Ching Hospital, Chung Kang Branch, Taichung City, Taiwan, R.O.C; 8Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi branch, Puzi City, Chiayi County, 61363, Taiwan, R.O.CCorrespondence: Yu-Hung FangDivision of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi branch, No.6, W. Sec., Jiapu Rd, Puzi City, Chiayi County, 61363, Taiwan, R.O.CTel [phone] ext. 2762Fax [phone]Email [email protected]: Sleep disturbances are common and symptomatic burden in patients with breast cancer, but they are poorly documented and managed in routine clinical practice. This descriptive and cross-sectional study evaluated factors associated with post-treatment sleep disturbances in patients with breast cancer.Patients and Methods: Patients with breast cancer who underwent standard treatment were enrolled and surveyed for their basic demographic data and precancerous and cancer treatment-related factors; they were also administered self-report questionnaires including the Family Adaptation, Partnership, Growth, Affection, Resolve questionnaire; Impact of Event Scale; Center for Epidemiologic Studies Depression Scale; and Maudsley Personality Inventory. Their sleep disturbances were evaluated using the Pittsburgh sleep quality index (PSQI). Independent sample t test and chi-square tests were used to compare the variables between patients with or without sleep disturbance, and multivariate logistic regression analyses were conducted to detect the independent factors.Results: In total, 448 patients, including 145 with PSQI ≤ 5 and 303 with PSQI > 5, completed the investigation. Multiple logistic regression analysis revealed that significantly more patients with sleep disturbances demonstrated psychological distress, severe pain, depression, and impact of stress events than patients without sleep disturbances (adjusted odds ratios [95% confidence intervals]: 2.83 [1.135– 7.067], P = 0.026; 1.14 [1.023– 1.280], P = 0.018; 1.08 [1.036– 1.133], P < 0.001; and 1.03 [1.002– 1.051], P = 0.037, respectively).Conclusion: Patients with breast cancer showed 67.6% prevalence of sleep disturbances after treatment. The patients with sleep disturbances were more likely to have previously experienced psychological disturbances, severe pain, depression within 5 years after diagnosis. After diagnosis for more than 5 years, higher distress caused by traumatic events still associated with sleep disturbances.Keywords: sleep disturbance, breast cancer, depression, pain, post-traumatic stress disorder, symptoms cluster

Keywords

• sleep disturbance
• breast cancer
• depression
• pain
• post-traumatic stress disorder
• symptoms cluster