Sleep problems increase risk of breast cancer progression in Chinese cohort

  • Liang ZZ & al.
  • Sleep Med
  • 12 Nov 2018

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Inadequate sleep duration, impaired daytime function, and poor sleep quality were among the sleep problems associated with increased progression of breast cancer.

Why this matters

  • Clinicians should ask patients with breast cancer about sleep problems and refer affected patients to care.

Study design

  • Prospective cohort of patients with breast cancer of all stages (n=1580) at a Chinese medical center.
  • Sleep problems were assessed by the self-reported Pittsburgh Sleep Quality Index.
  • Progression of breast cancer was one of these events: recurrence, metastasis, death, or other newly diagnosed disease.
  • Funding: National Natural Science Foundation of China.

Key results

  • Median follow-up was 4.2 years.
  • Increased risk of breast cancer progression was seen with these sleep problems:
    • long sleep duration (>9 hours vs 6-9 hours) (HR, 4.69; 95% CI, 1.31-16.78) and short sleep duration (
    • poor sleep quality (vs good) (HR, 3.08; 95% CI, 1.74-5.47); and
    • impaired daytime function (vs normal) (HR, 2.49; 95% CI, 1.65-3.79).
  • In stratified analysis of premenopausal patients, long sleep duration (HR, 3.17; 95% CI, 1.32-7.60) and short sleep duration (HR, 1.97; 95% CI, 1.01-3.84) increased progression, but not among postmenopausal patients.

Limitations

  • Observational design.
  • No information on exercise as confounding factor.

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