Distinct sleep and rest-activity profiles according to adjuvant treatment exposure in women treated for breast cancer.

BACKGROUND

The associations between adjuvant treatment combinations and sleep-wake processes in women treated for breast cancer remain poorly understood, thereby limiting the development of individualized supportive care. This exploratory study aims to investigate this effect in women treated for breast cancer receiving chemotherapy (CT) combined or not with radio- (RT) and endocrine (ET) therapies on sleep-wake processes and cancer-related fatigue.

PATIENTS AND

METHODS

Sixty-two participants were evaluated (21 patients receiving CT+RT+ET [CT group], 23 patients receiving RT+ET only [nonCT group], and 16 healthy control women [HC group]). Participants completed questionnaires assessing cancer-related fatigue and sleep complaints and wore a wrist actigraph for 72 hours to extract sleep-derived and rest-activity rhythm parameters. GLM served to compare groups when controlling for age and cancer stage. Correlation matrices were computed using Spearman's correlations to evaluate the links between variables in each patient' group.

RESULTS

Sleep complaints and cancer-related fatigue did not significantly differ between groups. The CT group had fewer but longer nocturnal awakenings and shorter sleep-onset latency compared to both nonCT and HC groups. The nonCT group had lower dichotomy index-reflecting robustness of the rest-activity rhythm-than the CT group but did not differ significantly from the HCs. Fatigue was negatively correlated with rest-activity rhythm amplitude in the nonCT group.

CONCLUSION

This exploratory study suggests that distinct patterns of sleep-wake parameters may be observed across the treatment exposure- groups (i.e., RT and ET + or - CT). These results should not be interpreted as evidence that treatment exposure itself explains the observed sleep-wake differences and require further investigation to be confirmed.

TRIAL REGISTRATION: This study was registered at https://clinicaltrials.gov/study/NCT04391543.