Comparison of subjectively and objectively assessed sleep problems in breast cancer patients starting neoadjuvant chemotherapy

Charlotte Kreutz,Karen Steindorf,Jana Müller,Martina E Schmidt

doi:10.1007/s00520-020-05580-0

Abstract

PurposeTo characterize sleep problems and to compare subjective and objective assessments in breast cancer patients starting neoadjuvant chemotherapy.MethodsSleep characteristics of 54 breast cancer patients starting neoadjuvant chemotherapy were analyzed. Subjective sleep characteristics were assessed with the Pittsburgh Sleep Quality Index (PSQI) and objective sleep measurements with an accelerometer (ActiGraph wGT3X-BT) worn on the wrist for 7 consecutive days.ResultsAccording to the common PSQI cut-off of 8, 10 (18.87%) of the patients were poor sleepers. ActiGraph measures did not mirror this classification as values for poor, and good sleepers did not differ significantly. Overall, Bland-Altman plots illustrated higher ActiGraph values for sleep efficiency and effective sleep time and lower values for sleep latency, compared with PSQI. For total sleep time, less disagreement between both measures was observed. Actigraphy was limited in precise identification of sleep begin and sleep latency but provided supplementary information about number and minutes of awakenings during the night.ConclusionSubjective and objective measurement methods differed substantially in various parameters, with limitations in both methods. A combination of both methods might be most promising.Trial RegistrationClinicaltrials.gov: NCT02999074

Highlights

IntroductionSleep disturbances are among the most common long-term health issues
In breast cancer survivors, sleep disturbances are among the most common long-term health issues
Parameters among breast cancer patients were similar to the normative values except for sleep disturbances which were significantly higher among patients

Summary

Introduction

Sleep disturbances are among the most common long-term health issues. Sleep disturbances are prevalent after menopause [1], but breast cancer survivors still have significantly more insomnia than women of comparable age of the general population [2]. Among disease-free breast cancer survivors 5 years after diagnosis, 38% reported sleep problems [3]. Chemotherapy and hot flashes, poor physical functioning, depressive symptoms, distress, quality of life, fatigue, and anxiety have been found to be significant predictors or correlates of insomnia [4]. Sleep problems are related with an increased risk of depression [5], chronic pain [6], cardiovascular diseases [7], and dementia [8].

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Discussion

Conclusion