Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
Exploring the influence and identifying key predictors of sleep difficulties on health status in long-term breast cancer survivors: a cross-sectional study.
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Álvarez-Salvago Francisco, Pujol-Fuentes Clara, Figueroa-Mayordomo Maria, Molina-García Cristina, Atienzar-Aroca Sandra, Jiménez-García José Daniel, Estornut Cristina, Gutiérrez-García Palmira, Medina-Luque Jose
Аннотация
PURPOSE: This study analyzed the relationship between different levels of sleep difficulties and physical, mental, and emotional variables in long-term breast cancer survivors (LTBCSs), and identified predictors of sleep-related complaints.
METHODS: Eighty LTBCSs participated in this cross-sectional study. Sleep difficulties were assessed via item 11 of the EORTC QLQ-C30, classifying participants into two groups: low (n = 44; ≤ 26.29) and high sleep difficulties (n = 36; ≥ 26.30). Additional measures included the EORTC QLQ-BR23, Piper Fatigue Scale, Visual Analog Scale, Brief Pain Inventory, International Fitness Scale, Minnesota Leisure Time Physical Activity questionnaire, and the Scale for Mood Assessment. Statistical analyses comprised ANOVA, Mann-Whitney U, Chi-square, correlation, and multiple regression; effect sizes were calculated using Cohen's d.
RESULTS: Fifty-five percent of LTBCSs reported higher sleep difficulties. This group showed greater physical, mental, and emotional impairments, including cancer-related fatigue (CRF), pain, lower self-perceived fitness, reduced physical activity (PA), worse mood, and diminished health-related quality of life (HRQoL) (all p < 0.05). Regression identified "role functioning" (β = -0.37; p < 0.01), "nausea and vomiting" (β = 0.37; p < 0.01), and "PA level" (β = -0.17; p = 0.02) as significant predictors of higher levels of sleep difficulties (adjusted r2 = 0.58).
CONCLUSION: Five or more years post-diagnosis, 55% of LTBCSs experienced higher sleep difficulties, associated with poorer HRQoL, self-perceived physical fitness, mood, and increased CRF and pain. Key predictors explained 58.4% of variance in sleep difficulties.
METHODS: Eighty LTBCSs participated in this cross-sectional study. Sleep difficulties were assessed via item 11 of the EORTC QLQ-C30, classifying participants into two groups: low (n = 44; ≤ 26.29) and high sleep difficulties (n = 36; ≥ 26.30). Additional measures included the EORTC QLQ-BR23, Piper Fatigue Scale, Visual Analog Scale, Brief Pain Inventory, International Fitness Scale, Minnesota Leisure Time Physical Activity questionnaire, and the Scale for Mood Assessment. Statistical analyses comprised ANOVA, Mann-Whitney U, Chi-square, correlation, and multiple regression; effect sizes were calculated using Cohen's d.
RESULTS: Fifty-five percent of LTBCSs reported higher sleep difficulties. This group showed greater physical, mental, and emotional impairments, including cancer-related fatigue (CRF), pain, lower self-perceived fitness, reduced physical activity (PA), worse mood, and diminished health-related quality of life (HRQoL) (all p < 0.05). Regression identified "role functioning" (β = -0.37; p < 0.01), "nausea and vomiting" (β = 0.37; p < 0.01), and "PA level" (β = -0.17; p = 0.02) as significant predictors of higher levels of sleep difficulties (adjusted r2 = 0.58).
CONCLUSION: Five or more years post-diagnosis, 55% of LTBCSs experienced higher sleep difficulties, associated with poorer HRQoL, self-perceived physical fitness, mood, and increased CRF and pain. Key predictors explained 58.4% of variance in sleep difficulties.