Abstract
Complaints of sleep disturbance are prevalent among breast cancer (BC) patients and are predictors of quality of life. Still, electrophysiological measures of sleep are missing in patients, which prevents from understanding the pathophysiological consequences of cancer and its past treatments. Using polysomnography, sleep can be investigated in terms of macro- (e.g. awakenings, sleep stages) and micro- (i.e. cortical activity) structure. We aimed to characterize sleep complaints, and macro- and microstructure in 33 BC survivors untreated by chemotherapy and that had finished radiotherapy since at least 6 months (i.e. out of the acute effects of radiotherapy) compared to 21 healthy controls (HC). Compared to HC, BC patients had a larger number of awakenings (p = 0.008); and lower Delta power (p < 0.001), related to sleep deepening and homeostasis; greater both Alpha (p = 0.002) and Beta power (p < 0.001), related to arousal during deep sleep; and lower Theta power (p = 0.004), related to emotion regulation during dream sleep. Here we show that patients have increased cortical activity related to arousal and lower activity related to sleep homeostasis compared to controls. These results give additional insights in sleep pathophysiology of BC survivors and suggest sleep homeostasis disruption in non-advanced stages of BC.
Highlights
Complaints of sleep disturbance are prevalent among breast cancer (BC) patients and are predictors of quality of life
During Stage 2, Beta power differed between groups with BC patients having higher Beta power (M = 9.30, SD = 2.8) than healthy controls (HC) (M = 8.45, SD = 3.0, p = 0.01)
Regarding spectral analyses of cortical EEG during sleep, results revealed modifications of power spectrum in Delta, Alpha and Beta bands during NREM sleep (i.e. Stages 1, 2 and 3) in BC patients compared to HC
Summary
Complaints of sleep disturbance are prevalent among breast cancer (BC) patients and are predictors of quality of life. Compared to HC, BC patients had a larger number of awakenings (p = 0.008); and lower Delta power (p < 0.001), related to sleep deepening and homeostasis; greater both Alpha (p = 0.002) and Beta power (p < 0.001), related to arousal during deep sleep; and lower Theta power (p = 0.004), related to emotion regulation during dream sleep. We show that patients have increased cortical activity related to arousal and lower activity related to sleep homeostasis compared to controls These results give additional insights in sleep pathophysiology of BC survivors and suggest sleep homeostasis disruption in non-advanced stages of BC. One study reported larger duration of NREM Stage 2 following radiotherapy in breast cancer patients compared to healthy controls[19]. A recent meta-analysis reported increased Alpha, Sigma and Beta power and lower Delta power compare to healthy adults, notably during NREM s leep[27]
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