The impact of chemotherapy on sleep quality in women undergoing cytotoxic treatment for breast, ovarian, and endometrial cancer.

Abstract

e23077 Background: To determine changes in sleep quality among women with breast, ovarian, and endometrial cancer during chemotherapy and to assess the impact of sleep quality on quality of life (QOL). Methods: A prospective cohort study was performed at The Program in Women’s Oncology among chemotherapy naïve women diagnosed with breast, ovarian, or endometrial cancer scheduled to begin treatment. Ovarian and endometrial patients were combined into one group (Gyn) for analysis. Two validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI) and the Functional Assessment of Cancer Therapy (FACT), which measure sleep quality and QOL, respectively, were administered prior to-, halfway through-, completion of-, and 6 months after chemotherapy completion. Descriptive statistics were used to summarize baseline characteristics. Categorical variables were compared by Chi-square (χ2) test and continuous variables by T-test. The PSQI and FACT scores were analyzed by linear or logistic regression with GEEs. Results: Of the 99 women enrolled, 27 had ovarian, 23 had endometrial, and 49 had breast cancer. 97 were included in the analysis. The breast cohort was younger than their Gyn counterparts: 50 vs. 62, (p < .001), and more likely to identify as Hispanic (p = .012). 56% of women endorsed poor sleep quality at baseline. By mid-treatment, both cohorts reported a significant reduction in sleep quality (p = .008) and QOL (p = .0003) that did not persist at end of- or 6 months post-treatment. Increased need for sleep medications (p = .012) and reduction in sleep efficiency (p = .002) were identified mid-treatment. No significant changes in PSQI or FACT-G were seen by end of treatment. At 6 months post treatment, less Gyn patients reported poor sleep quality when compared to baseline (46 vs 53%) while experiencing a significant improvement in QOL (p = .03). Poor sleep quality was correlated with worse QOL at all time points (p < .001). Conclusions: There is a sparsity of research on sleep disturbances in gynecologic malignancies. In this study, three quarters of all women reported poor sleep quality by mid-treatment with concomitant decrease in QOL. Poor sleep was reported by nearly 50% of women at all other time points. Larger studies need to be done to further define the problem and identify areas suitable for interventions.