Sleep and survival among women with breast cancer: 30 years of follow- up within the Nurses' Health Study

被引：67

作者：

Trudel-Fitzgerald, Claudia ^{[1
]}

Zhou, Eric S. ^{[2
,3
]}

Poole, Elizabeth M. ^{[4
]}

Zhang, Xuehong ^{[4
,5
]}

Michels, Karin B. ^{[6
]}

Eliassen, A. Heather ^{[4
,5
]}

Chen, Wendy Y. ^{[2
,3
,4
]}

Holmes, Michelle D. ^{[4
,5
]}

Tworoger, Shelley S. ^{[4
,5
]}

Schernhammer, Eva S. ^{[4
,5
,7
]}

机构：

[1] Harvard TH Chan Sch Publ Hlth, Dept Social & Behav Sci, 677 Huntington Ave, Boston, MA 02115 USA

[2] Harvard Med Sch, Dept Med, 25 Shattuck St, Boston, MA 02115 USA

[3] Dana Farber Canc Inst, Dept Med Oncol, 450 Brookline Ave, Boston, MA 02215 USA

[4] Brigham & Womens Hosp, Channing Div Network Med, Dept Med, 181 Longwood Ave, Boston, MA 02115 USA

[5] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, 677 Huntington Ave, Boston, MA 02115 USA

[6] Univ Calif Los Angeles, Fielding Sch Publ Hlth, Dept Epidemiol, 650 Charles E Young Dr S, Los Angeles, CA 90095 USA

[7] Med Univ Vienna, Dept Epidemiol, Marianneng 14 Top 105, A-1090 Vienna, Austria

来源：

BRITISH JOURNAL OF CANCER | 2017年 / 116卷 / 09期

基金：

加拿大健康研究院;

关键词：

sleep duration; sleep difficulties; breast cancer; diagnosis; survival; mortality; ALL-CAUSE MORTALITY; PROSTATE-CANCER; CIRCADIAN DISRUPTION; PROSPECTIVE COHORT; LUNG-CANCER; DURATION; RISK; INSOMNIA; METAANALYSIS; FATIGUE;

D O I：

10.1038/bjc.2017.85

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Breast cancer is a leading cause of cancer death in women. Sleep has been linked with mortality among cancer-free population; however, its association with survival among women with breast cancer is understudied. Methods: Breast cancer patients (N = 3682) reported their average sleep duration post diagnosis. Subsamples also provided their pre-diagnosis sleep duration (n = 1949) and post-diagnosis sleep difficulties (n = 1353). Multivariate Cox models estimated hazard ratios (HR) and confidence intervals (CI) of all-cause, breast cancer, and non-breast cancer mortality. Results: At diagnosis, the mean age was 64.9 years and 91.7% were stage I or II. Women sleeping >= 9 h per night post diagnosis had a strong higher risk of all-cause (multivariate HRs: MV-HR = 1.37, CI = 1.10-1.71), breast cancer (MV-HR = 1.46, CI = 1.02-2.07), and non-breast cancer mortality (MV-HR = 1.34, CI = 1.01-1.79), compared to women sleeping 8 h per night. Increased sleep duration post diagnosis (vs unchanged) and regular sleep difficulties (vs rare/none) were associated with a strong elevated risk of all-cause mortality (MV-HRincreased (duration) = 1.35, CI = 1.04-1.74; MV-HRregular difficulties = 1.49, CI = 1.02-2.19) and a moderate greater risk of breast cancer and non-breast cancer mortality. Conclusions: Various facets of sleep were associated with higher all-cause mortality risk. If replicated, these findings support evaluation of breast cancer patients' sleep duration and difficulties to identify those at risk for poorer outcomes.

引用

页码：1239 / 1246

页数：8

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