Quality of sleep and related factors during chemotherapy in patients with stage I/II breast cancer
Quality of sleep and related factors during chemotherapy in patients with stage I/II breast cancer
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DOI：
10.1016/s0929-6646(09)60110-8
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发表时间：
2006-01-01
影响因子：
3.2
通讯作者：
Hwang, SL
中科院分区：
文献类型：
--
作者：
Kuo, HH;Chiu, MJ;Hwang, SL
背景：失眠会给接受化疗的乳腺癌患者带来严重的痛苦。很少有研究专注于使用客观方法来评估睡眠。探讨乳腺癌患者化疗期间的睡眠质量及相关因素。方法：16例I、II期乳腺癌患者接受环磷酰胺、表阿霉素、氟尿嘧啶或环磷酰胺、甲氨蝶呤、氟尿嘧啶的第三周期化疗。在第3周期的第8天和第9天，即副作用活动期，以及第4周期开始前的最后2天评估化疗对睡眠的影响，以进行比较。用于评估睡眠质量及相关因素的工具包括活动记录仪、医院焦虑和抑郁量表(HADS)、症状困难量表(SDS)、疲劳视觉模拟量表(FVAS)、Epworth嗜睡量表(ESS)和睡眠日志。结果：活动期患者表现出焦虑倾向，HADS平均得分为7.8+/-3.8。FVAS评分平均为4+/-2，表示轻度疲劳，而抑郁自评量表评分(1.8+/-0.3)也表示轻度症状困扰。根据睡眠记录，每晚醒来的次数为2.2+/-1.6次，根据Actiwatch的数据，这些事件期间的总清醒时间为47.8+/-26.1分钟。Actiwatch在活动期测得的睡眠效率比正常范围低82.1+/-9.4%。ESS评定的日间嗜睡表现为活动期轻度嗜睡(6.0+/-3.5)。结论：乳腺癌患者化疗活动期睡眠质量差，白天嗜睡。化疗可能会给患者带来症状困扰，并对睡眠质量产生不利影响。
Background: Insomnia causes severe distress in patients with breast cancer who receive chemotherapy. Few studies have focused on using objective methods to assess sleep. This study explored the quality of sleep and related factors in patients with breast cancer during chemotherapy.Methods: The participants were 16 women with stage I or II breast cancer receiving their third cycle of chemotherapy with cyclophosphamide, epirubicin and fluorouracil, or cyclophosphamide, methotrexate and fluorouracil. The effects of chemotherapy on sleep were assessed on the 8(th) and 9(th) days of the third cycle, i.e. the active phase in terms of side effects, and the last 2 days before the start of the fourth cycle for comparison. Instruments used to assess sleep quality and related factors included actigraphy, the Hospital Anxiety and Depression Scale (HADS), the Symptom Distress Scale (SDS), the Fatigue Visual Analogue Scale (FVAS), the Epworth Sleepiness Scale (ESS), and sleep logs.Results: During the active phase, patients showed an anxiety tendency with an average HADS score of 7.8 +/- 3.8. The average FVAS score was 4 +/- 2, indicative of mild fatigue, and SDS score (1.8 +/- 0.3) also indicated mild symptom distress. The number of awakenings each night was 2.2 +/- 1.6 by sleep logs, and the total time spent awake during these episodes was 47.8 +/- 26.1 minutes by Actiwatch. Sleep efficiency measured by Actiwatch in the active phase was 82.1 +/- 9.4% below the normal limit. Daytime sleepiness assessed by ESS showed mild sleepiness (6.0 +/- 3.5) in the active phase.Conclusion: The study showed poor sleep quality and daytime sleepiness in patients with breast cancer during the active phase of chemotherapy. Chemotherapy may bring symptom distress to patients and adversely influence sleep quality.