A comparison of disrupted sleep patterns in women with cancer-related fatigue and postmenopausal women without cancer.

PURPOSE: Fatigue and disrupted sleep often coexist and both are prominent clinical problems in cancer affecting quality of life. Disrupted sleep patterns are likely related to cancer-related fatigue. The relationship needs further investigation. This study aimed to characterize and compare disrupted sleep patterns in fatigued breast cancer patients receiving chemotherapy with postmenopausal women without a history of cancer. Anxiety levels were also examined.

METHODS

Data for this secondary analysis came from two studies. Global sleep quality and state anxiety were self-reported by 30 fatigued female breast cancer chemotherapy outpatients and 32 non-cancer postmenopausal women using Pittsburgh Sleep Quality Index (PSQI) and State-Trait Anxiety Inventory, respectively.

RESULTS

Fatigued breast cancer patients showed significant sleep difficulties, characterized by prolonged sleep onset latency (M=54.3, SD=49.2 min) and frequent nighttime awakenings, despite 40% of the patients using sleep medications three or more times a week. Compared to the non-cancer comparison group, fatigued patients reported significantly longer sleep latency (p=0.041), more use of sleep medications (p=0.006), and higher total PSQI scores (p=0.005). State anxiety levels did not differ between the two groups (p=0.88).

CONCLUSIONS

Sleep is disrupted in fatigued breast cancer women undergoing chemotherapy. Nearly all fatigued patients (97%) had trouble sleeping (global PSQI scores>5), indicating significant difficulties in overall sleep quality among those patients. Knowledge of the nature of sleep disruption among cancer patients may contribute to CRF symptom management leading to tailored interventions designed to improve sleep quality in cancer patients thereby managing fatigue and improving quality of life.