Repeated chemotherapy cycles produced progressively worse and enduring impairments in the sleep–wake profile of hospitalized breast cancer patients

ABSTRACT

Cross-sectional studies, conducted previously, reported disruption of the sleep–wake rhythms of cancer patients on chemotherapy. Although few studies highlighted the effect of hospitalization on sleep, no data were obtained on the effects of longitudinal repeated chronotherapy cycles on sleep pattern of cancer patients. In this study, using the two-factor repeated-measures design, we attempted to assess longitudinally the quality and pattern in sleep–wake behavior of breast cancer in- and outpatients, who received multiple cycles of chemotherapy. We randomly selected the patients from the Regional Cancer Center, Dr. B.R. Ambedkar Memorial Hospital, Raipur, India. We used wrist-worn actigraphs to record the sleep–wake pattern both objectively and subjectively. Additionally, we administered Pittsburgh Sleep Quality Index questionnaire to each patient. Results revealed statistically significant effects of chemotherapy with and without hospitalization mostly on all objective [total sleep time, sleep onset latency, wake after sleep onset, fragmentation index, and sleep efficiency (SE)] and subjective [duration of sleep, sleep disturbance, sleep latency, daytime dysfunction due to sleepiness, SE, and overall sleep quality] sleep–wake parameters of cancer patients. Cancer patients, who received repeated chemotherapy administration followed by hospitalization on each occasion, experienced severely impaired sleep–wake cycle as compared with those who went home after receiving chemotherapy.

KEYWORDS:

• Actigraphs
• breast cancer
• chemotherapy
• hospitalization
• inpatients
• outpatients
• Pittsburgh Sleep Quality Index
• sleep quality

Acknowledgments

We are grateful to the University Grants Commission, New Delhi, India, for providing one of us (AS) with the BSR fellowship through the DRS-SAP scheme sanctioned in the thrust area – Chronobiology to the School of Studies in Life Science, Pt. Ravishankar Shukla University, Raipur, India. We are grateful to all cancer patients, who voluntarily participated in the current study. We are also obliged to Mary Ann Muller, the Permissions Coordinator of the Taylor & Francis LLC for permitting us to use Table 1 from our earlier publication [Sultan et al., Chronobiology International, 2018; 35(11):1513-1532].

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Chhattisgarh Council of Science & Technology (CCOST), Raipur, India, under Grant number [8048/CCOST/MRP/2013] dated 27/12/2013.