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Cited by 161Cancer survivorship and careCancer-related cognitive impairment studiesSleep and related disorders

Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy

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Fox, Rina S., Ancoli-Israel, Sonia, Roesch, Scott C., Merz, Erin L., Mills, Sarah D., Wells, Kristen J., Sadler, Georgia Robins, Malcarne, Vanessa L.·2020·Supportive Care in Cancer
DOI 10.1007/s00520-019-04834-wPMC PMC6959513
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Abstract

Purpose Sleep disturbance and cancer-related fatigue (CRF) are among the most commonly reported symptoms associated with breast cancer and its treatment. This study identified symptom cluster groups of breast cancer patients based on multidimensional assessment of sleep disturbance and CRF prior to and during chemotherapy. Methods Participants were 152 women with stage I-IIIA breast cancer. Data were collected before chemotherapy (T1) and during the final week of the fourth chemotherapy cycle (T2). Latent profile analysis was used to derive groups of patients at each timepoint who scored similarly on percent of the day/night asleep per actigraphy, the Pittsburgh Sleep Quality Index global score, and the five subscales of the Multidimensional Fatigue Symptom Inventory-Short Form. Bivariate logistic regression evaluated if sociodemographic/medical characteristics at T1 were associated with group membership at each timepoint. Results Three groups (Fatigued with sleep complaints, Average, Minimal symptoms) were identified at T1, and five groups (Severely fatigued with poor sleep, Emotionally fatigued with average sleep, Physically fatigued with average sleep, Average, Minimal symptoms) at T2. The majority of individuals in a group characterized by more severe symptoms at T1 were also in a more severe symptom group at T2. Sociodemographic/medical variables at T1 were significantly associated with group membership at T1 and T2. Conclusions This study identified groups of breast cancer patients with differentially severe sleep disturbance and CRF symptom profiles prior to and during chemotherapy. Identifying groups with different symptom management needs and distinguishing groups by baseline sociodemographic/medical variables can identify patients at risk for greater symptom burden.

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  • Smoking-cessation drugs and some treatments for cancer have been shown to reduce patients' sleep quality.

    “For example, smoking-cessation drugs and some treatments for cancer have been shown to reduce patients’ sleep quality126,129.”

    From The future of sleep health: a data-driven revolution in sleep science and medicine (2020) · cites this paper as [126]

    The Introduction describes sleep disturbance as common in breast cancer, and the Abstract’s Purpose calls it a symptom associated with breast cancer and its treatment. The study measured sleep before and during chemotherapy, but these passages do not establish that treatment reduced sleep quality. The paper does not address smoking-cessation drugs, which appear to be the other citation’s part of the sentence. (LLM, conf=0.83)

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  • Poor sleep quality can worsen symptoms of many serious and chronic conditions, including cancer and multiple sclerosis.

    “Aside from its direct role in ill-health, poor sleep quality can worsen the symptoms of many serious and chronic conditions, including cancer and multiple sclerosis126–128.”

    From The future of sleep health: a data-driven revolution in sleep science and medicine (2020) · cites this paper as [126]

    The Introduction (page not provided) says sleep disturbance and cancer-related fatigue are highly comorbid in breast cancer and are associated with increased symptom burden. That supports a link between poor sleep and cancer symptoms, but the paper does not establish that poor sleep worsens those symptoms. This citation addresses breast cancer, not the sentence’s separate multiple-sclerosis example. (LLM, conf=0.85)

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Authors
Fox, R. S., Ancoli-Israel, S., Roesch, S. C., Merz, E. L., Mills, S. D., Wells, K. J., Sadler, G. R., & Malcarne, V. L.
Affiliations
  • Northwestern University (US)
  • San Diego State University (US)
  • California State University, Dominguez Hills (US)
  • University of North Carolina at Chapel Hill (US)
Corresponding author
Malcarne, Vanessa L.
ORCID
Venue
Supportive Care in Cancer
Publisher
Springer Science and Business Media LLC
Published
2019-06-03
Volume
28
Issue
2
Pages
845-855
ISSN
  • 0941-4355 (ISSN-L)
  • 1433-7339
DOI
10.1007/s00520-019-04834-w
PMC
PMC6959513
OpenAlex
W2948165906
Cited by
161
References
7
Citations by year
2026: 16 · 2025: 24 · 2024: 43 · 2023: 27 · 2022: 30 · 2021: 14 · 2020: 6
FWCI
5.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Supportive Care in Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Cancer Institute (CA112035, UL1RR03198)
  • National Institutes of Health (M01 RR00827)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
sleep disorders, cancer-related fatigue, breast cancer, chemotherapy, symptom clusters, actigraphy, Pittsburgh Sleep Quality Index, symptom burden, patient subgroups, sociodemographic predictors
MeSH terms
Breast Neoplasms, Fatigue, Female, Humans, Middle Aged, Sleep Wake Disorders, Syndrome

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