Insomnia and Susceptibility to Depressive Symptoms and Fatigue in Diverse Breast Cancer Survivors.
Insomnia and Susceptibility to Depressive Symptoms and Fatigue in Diverse Breast Cancer Survivors.
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DOI：
10.1089/jwh.2019.8135
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Irwin MR
中科院分区：
文献类型：
--
作者：
Haque R;Hsu JW;Avila C;Olmstead R;Carroll JE;Irwin MR
研究背景：近40%的乳腺癌幸存者患有失眠症，然而，缺乏这种疾病如何影响他们生活质量的信息。我们研究了乳腺癌幸存者失眠和抑郁症状及疲劳之间的关系。方法：参与者从社区健康计划中招募。我们对315名没有重度抑郁症的乳腺癌幸存者进行了一项横断面分析，以检查当前失眠（使用失眠严重程度指数[ISI]）与当前抑郁症状（使用抑郁症状量表[IDS]）和疲劳（使用疲劳症状量表[FSI]）之间的关系。我们使用多变量逻辑回归计算比值比（OR）和95%置信区间（CI）。结果：该队列包括30%的少数民族妇女，其自乳腺癌诊断以来的中位时间为6年。在调整终生失眠史（OR = 2.01，95%CI：1.03-3.94）和感知压力（OR = 6.37，95%CI：2.48 -16.32）后，当前有失眠症状（ISI ≥8）的幸存者当前抑郁症状的几率（IDS >14，OR = 5.98，95%CI：3.04 -11.76）高6倍。疲劳症状与中度疲劳显著相关（FSI >3，OR = 5.02，95% CI：2.66-9.44）。在乳腺癌诊断后使用抗抑郁药或睡眠药物与那些有失眠症状的人目前抑郁症状或感到疲劳的几率较低无关。结论：当前失眠症状与当前抑郁症状和疲劳密切相关。幸存者护理计划应考虑将失眠筛查纳入可能提高生活质量的领域。
Background: Nearly 40% of breast cancer survivors have insomnia, yet, information how this condition affects their quality of life is lacking. We examined the association between insomnia and depressive symptoms and fatigue in breast cancer survivors. Methods: Participants were recruited from a community health plan. We conducted a cross-sectional analysis to examine the association between current insomnia (using Insomnia Severity Index [ISI]) and current depressive symptoms (using Inventory of Depressive Symptomology [IDS]) and fatigue (using Fatigue Symptom Inventory [FSI]) in 315 breast cancer survivors who did not have major depressive disorder. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariable logistic regression. Results: The cohort included 30% minority women whose median time since breast cancer diagnosis was 6 years. Survivors with current insomnia symptoms (ISI ≥8) had a sixfold greater odds of current depressive symptoms (IDS >14, OR = 5.98, 95% CI: 3.04–11.76), after adjusting for lifetime insomnia history (OR = 2.01, 95% CI: 1.03–3.94) and perceived stress (OR = 6.37, 95% CI: 2.48–16.32). Insomnia symptoms were markedly associated with moderate fatigue (FSI >3, OR = 5.02, 95% CI: 2.66–9.44). Ever use of antidepressants or sleep medications post-breast cancer diagnosis was not associated with lower odds of current depressive symptoms or feeling fatigued in those with insomnia symptoms. Conclusion: Current insomnia symptoms were strongly correlated with current depressive symptoms and fatigue. Survivorship care plans should consider incorporating insomnia screening to that may potentially enhance quality of life domains.
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影响因子：
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作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
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