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Cited by 15

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Reductions in sleep quality and circadian activity rhythmicity predict longitudinal changes in objective and subjective cognitive functioning in women treated for breast cancer

Ancoli-Israel, Sonia, Liu, Lianqi, Natarajan, Loki, Rissling, Michelle, Neikrug, Ariel B., Youngstedt, Shawn D., Mills, Paul J., Sadler, Georgia R., Dimsdale, Joel E., Parker, Barbara A., Palmer, Barton W.·2022·Supportive Care in Cancer
DOI 10.1007/s00520-021-06743-3
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Abstract

Purpose: To examine long-term cognitive effects of chemotherapy and identify predictors among women with breast cancer (WBC). Patients and methods: Sixty-nine WBC scheduled to receive chemotherapy, and 64 matched-controls with no cancer, participated. Objective and subjective cognition, total sleep time, nap time, circadian activity rhythms (CAR), sleep quality, fatigue, and depression were measured pre-chemotherapy (Baseline), end of cycle 4 (Cycle-4), and one-year post-chemotherapy (1-Year). Results: WBC showed no change in objective cognitive measures from Baseline to Cycle-4 but significantly improved from both time points to 1-Year. Matched-controls showed an increase in test performance at all time points. WBC had significantly higher self-reported cognitive dysfunction at Cycle-4 and 1-Year compared to baseline and compared to matched-controls. Worse neuropsychological functioning was predicted by less robust CARs (i.e., inconsistent 24 h pattern), worse sleep quality, longer naps, and worse cognitive complaints. Worse subjective cognition was predicted by lower sleep quality and higher fatigue and depressed mood. Conclusion: Objective testing showed increases in performance scores from pre- and post-chemotherapy to one year later in WBC, but matched-controls showed an increase in test performance from baseline to Cycle-4 and from Cycle-4 to 1-Year, likely due to a practice effect. The fact that WBC showed no practice effects may reflect a form of learning deficit. Compared with the matched-controls, WBC reported significant worsened cognitive function. In WBC, worse objective and subjective cognitive functioning were predicted by worse sleep and sleep-related behaviors (naps and CAR). Interventions that target sleep, circadian rhythms, and fatigue may benefit cognitive function in WBC.

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Cited by

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Metadata

Authors
Ancoli-Israel, S., Liu, L., Natarajan, L., Rissling, M., Neikrug, A. B., Youngstedt, S. D., Mills, P. J., Sadler, G. R., Dimsdale, J. E., Parker, B. A., & Palmer, B. W.
Venue
Supportive Care in Cancer
Publisher
Springer Science and Business Media LLC
Published
2021-12-26
Volume
30
Issue
4
Pages
3187-3200
ISSN
  • 0941-4355
  • 1433-7339
DOI
10.1007/s00520-021-06743-3
Cited by
15
References
1
Language
en
Licence
Funders
  • National Cancer Institute (CA112035)
  • National Institutes of Health (UL1RR031980)
  • U.S. Department of Veterans Affairs (CESAMH)

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