Purpose. The purpose of this descriptive study was to examine sleep in older women with non-metastatic breast cancer.
Sample. Sixty-seven women 50 to 90 years of age (mean 64.9 years, SD=4.67), including one group with (n=32) and one without breast cancer (n=35) composed the convenience sample. Participants were predominantly white (93%), single (54%), retired (57%), had incomes under $60,000 per year (77%), had less than four comorbidities (61%), and took no sleep medication (66%). Demographic factors were similar in the two groups.
Methods. Participants completed three days of home actigraphy, the Pittsburgh Sleep Diary and two telephone interviews including a demographic survey, the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Insomnia Severity Index, and Profile of Mood States. Charts were reviewed for the breast cancer group.
Findings. Multiple regression analysis revealed that subjective sleep quality was predicted by depressed mood (p=0.0000). Both groups had poor subjective sleep quality (8 vs 6; expected >7 & >5 respectively), while objective sleep quality (sleep efficiency) and depressed mood were within expected limits (91 vs 93%; t-scores of 54 vs 50 respectively).
The two groups similar nocturnal awakenings (9 vs 7; expected 2-6/night) and day sleep time (129 vs 120 minutes; expected 14-31 minutes/day), exceeding expected limits. Mean sleep onset latency was longer (35 vs 16 minutes; expected < 35 minutes) in the breast cancer group (p=0.005). Mean insomnia severity scores (9 vs 6; normal under 8) reflected sub-threshold insomnia in the breast cancer group, with score categories indicating more moderate and severe insomnia symptoms (19% vs 9%). Mean daytime sleepiness was similar in both groups (7.16 vs 5.57; expected > 9), with score categories indicating excessive sleepiness in approximately one-fifth (cases 22% vs comparisons 20%). Only sleep onset latency was found to be borderline significantly different (p=0.005) between groups with an adjusted alpha of 0.005.
Conclusions. Subjective sleep quality was poor and predicted by depressed mood, although depressed mood and objective sleep quality were within expected limits. Objective sleep, insomnia symptoms and daytime sleepiness were similar for groups, but the breast cancer group had shorter sleep onset latency and more severe insomnia symptom.
|Advisor:||Coleman, E. Ann|
|School:||University of Arkansas for Medical Sciences|
|School Location:||United States -- Arkansas|
|Source:||DAI-B 70/04, Dissertation Abstracts International|
|Keywords:||Breast cancer, Cancer, Depression, Geriatrics, Nursing, Older women, Sleep|
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