Abstract
Simple SummaryThis is the first study to estimate the effects of pre-existing sleep disorders on the survival outcomes of patients with breast cancer after receiving standard treatments. We conducted a head-to-head propensity score matching study to mimic a randomized trial to compare the survival rates of women with both sleep disorders and breast cancer. Women with pre-existing sleep disorders receiving curative treatments for breast cancer had poorer survival outcomes than those without sleep disorders. Therefore, patients should be screened and evaluated for pre-existing sleep disorders prior to breast surgery, with such disorders serving as survival predictors in patients with breast cancer. Future studies may investigate the survival benefits of pharmacological and behavioral treatments for sleep problems in patients with breast cancer.PURPOSE: To investigate the effects of pre-existing sleep disorders on the survival outcomes of women receiving standard treatments for breast invasive ductal carcinoma (IDC). METHODS: We recruited patients from the Taiwan Cancer Registry Database who had received surgery for clinical stage I–III breast IDC. The Cox proportional hazards model was used to analyze all-cause mortality. We categorized the patients into those with and without sleep disorders (Groups 1 and 2, respectively) through propensity score matching. RESULTS: In the multivariate Cox regression analysis, the adjusted hazard ratio for all-cause mortality for Group 1 compared with Group 2 was 1.51 (95% confidence interval: 1.19, 1.91; p < 0.001). CONCLUSION: Our study demonstrated that the sleep disorder group had poorer survival rates than the non-sleep disorder group in breast cancer. Therefore, patients should be screened and evaluated for pre-existing sleep disorders prior to breast surgery, with such disorders serving as a predictor of survival in patients with breast cancer. Future studies may investigate the survival benefits of pharmacological and behavioral treatments for sleep problems in patients with breast cancer.
Highlights
Sleep disorders are prevalent in women with breast cancer
Studies have determined that patients with breast cancer tend to have a higher mortality risk if they have sleep problems prior to their breast cancer diagnosis, the data are controversial for sleep disorders and cancer survival [14,15]
This study revealed a significant relationship between pre-existing sleep disorders and breast cancer mortality
Summary
Sleep disorders are prevalent in women with breast cancer. Approximately 60% to 90%of patients with breast cancer have sleep disturbances, which is a higher prevalence than that found in other types of cancer [1,2,3,4,5]. Studies have determined that patients with breast cancer tend to have a higher mortality risk if they have sleep problems prior to their breast cancer diagnosis, the data are controversial for sleep disorders and cancer survival [14,15]. These studies have reported inconsistent findings concerning the influence of sleep quality on the risk of death in patients with breast cancer [14,15]
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