Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy

Rina S. Fox, Sonia Ancoli-Israel, Scott C. Roesch, Erin L. Merz, Sarah D. Mills, Kristen J. Wells, Georgia Robins Sadler, Vanessa L. Malcarne*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Purpose: Sleep disturbance and cancer-related fatigue (CRF) are among the most commonly reported symptoms associated with breast cancer and its treatment. This study identified symptom cluster groups of breast cancer patients based on multidimensional assessment of sleep disturbance and CRF prior to and during chemotherapy. Methods: Participants were 152 women with stage I–IIIA breast cancer. Data were collected before chemotherapy (T1) and during the final week of the fourth chemotherapy cycle (T2). Latent profile analysis was used to derive groups of patients at each timepoint who scored similarly on percent of the day/night asleep per actigraphy, the Pittsburgh Sleep Quality Index global score, and the five subscales of the Multidimensional Fatigue Symptom Inventory-Short Form. Bivariate logistic regression evaluated if sociodemographic/medical characteristics at T1 were associated with group membership at each timepoint. Results: Three groups (Fatigued with sleep complaints, Average, Minimal symptoms) were identified at T1, and five groups (Severely fatigued with poor sleep, Emotionally fatigued with average sleep, Physically fatigued with average sleep, Average, Minimal symptoms) at T2. The majority of individuals in a group characterized by more severe symptoms at T1 were also in a more severe symptom group at T2. Sociodemographic/medical variables at T1 were significantly associated with group membership at T1 and T2. Conclusions: This study identified groups of breast cancer patients with differentially severe sleep disturbance and CRF symptom profiles prior to and during chemotherapy. Identifying groups with different symptom management needs and distinguishing groups by baseline sociodemographic/medical variables can identify patients at risk for greater symptom burden.

Original languageEnglish (US)
Pages (from-to)845-855
Number of pages11
JournalSupportive Care in Cancer
Volume28
Issue number2
DOIs
StatePublished - Feb 1 2020

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Fatigue
Sleep
Breast Neoplasms
Drug Therapy
Neoplasms
Actigraphy
Logistic Models
Equipment and Supplies

Keywords

  • Cancer
  • Cancer-related fatigue
  • Latent profile analysis
  • Oncology
  • Sleep disturbance
  • Symptom cluster

ASJC Scopus subject areas

  • Oncology

Cite this

Fox, R. S., Ancoli-Israel, S., Roesch, S. C., Merz, E. L., Mills, S. D., Wells, K. J., ... Malcarne, V. L. (2020). Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy. Supportive Care in Cancer, 28(2), 845-855. https://doi.org/10.1007/s00520-019-04834-w
Fox, Rina S. ; Ancoli-Israel, Sonia ; Roesch, Scott C. ; Merz, Erin L. ; Mills, Sarah D. ; Wells, Kristen J. ; Sadler, Georgia Robins ; Malcarne, Vanessa L. / Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy. In: Supportive Care in Cancer. 2020 ; Vol. 28, No. 2. pp. 845-855.
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Fox, RS, Ancoli-Israel, S, Roesch, SC, Merz, EL, Mills, SD, Wells, KJ, Sadler, GR & Malcarne, VL 2020, 'Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy', Supportive Care in Cancer, vol. 28, no. 2, pp. 845-855. https://doi.org/10.1007/s00520-019-04834-w

Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy. / Fox, Rina S.; Ancoli-Israel, Sonia; Roesch, Scott C.; Merz, Erin L.; Mills, Sarah D.; Wells, Kristen J.; Sadler, Georgia Robins; Malcarne, Vanessa L.

In: Supportive Care in Cancer, Vol. 28, No. 2, 01.02.2020, p. 845-855.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy

AU - Fox, Rina S.

AU - Ancoli-Israel, Sonia

AU - Roesch, Scott C.

AU - Merz, Erin L.

AU - Mills, Sarah D.

AU - Wells, Kristen J.

AU - Sadler, Georgia Robins

AU - Malcarne, Vanessa L.

PY - 2020/2/1

Y1 - 2020/2/1

N2 - Purpose: Sleep disturbance and cancer-related fatigue (CRF) are among the most commonly reported symptoms associated with breast cancer and its treatment. This study identified symptom cluster groups of breast cancer patients based on multidimensional assessment of sleep disturbance and CRF prior to and during chemotherapy. Methods: Participants were 152 women with stage I–IIIA breast cancer. Data were collected before chemotherapy (T1) and during the final week of the fourth chemotherapy cycle (T2). Latent profile analysis was used to derive groups of patients at each timepoint who scored similarly on percent of the day/night asleep per actigraphy, the Pittsburgh Sleep Quality Index global score, and the five subscales of the Multidimensional Fatigue Symptom Inventory-Short Form. Bivariate logistic regression evaluated if sociodemographic/medical characteristics at T1 were associated with group membership at each timepoint. Results: Three groups (Fatigued with sleep complaints, Average, Minimal symptoms) were identified at T1, and five groups (Severely fatigued with poor sleep, Emotionally fatigued with average sleep, Physically fatigued with average sleep, Average, Minimal symptoms) at T2. The majority of individuals in a group characterized by more severe symptoms at T1 were also in a more severe symptom group at T2. Sociodemographic/medical variables at T1 were significantly associated with group membership at T1 and T2. Conclusions: This study identified groups of breast cancer patients with differentially severe sleep disturbance and CRF symptom profiles prior to and during chemotherapy. Identifying groups with different symptom management needs and distinguishing groups by baseline sociodemographic/medical variables can identify patients at risk for greater symptom burden.

AB - Purpose: Sleep disturbance and cancer-related fatigue (CRF) are among the most commonly reported symptoms associated with breast cancer and its treatment. This study identified symptom cluster groups of breast cancer patients based on multidimensional assessment of sleep disturbance and CRF prior to and during chemotherapy. Methods: Participants were 152 women with stage I–IIIA breast cancer. Data were collected before chemotherapy (T1) and during the final week of the fourth chemotherapy cycle (T2). Latent profile analysis was used to derive groups of patients at each timepoint who scored similarly on percent of the day/night asleep per actigraphy, the Pittsburgh Sleep Quality Index global score, and the five subscales of the Multidimensional Fatigue Symptom Inventory-Short Form. Bivariate logistic regression evaluated if sociodemographic/medical characteristics at T1 were associated with group membership at each timepoint. Results: Three groups (Fatigued with sleep complaints, Average, Minimal symptoms) were identified at T1, and five groups (Severely fatigued with poor sleep, Emotionally fatigued with average sleep, Physically fatigued with average sleep, Average, Minimal symptoms) at T2. The majority of individuals in a group characterized by more severe symptoms at T1 were also in a more severe symptom group at T2. Sociodemographic/medical variables at T1 were significantly associated with group membership at T1 and T2. Conclusions: This study identified groups of breast cancer patients with differentially severe sleep disturbance and CRF symptom profiles prior to and during chemotherapy. Identifying groups with different symptom management needs and distinguishing groups by baseline sociodemographic/medical variables can identify patients at risk for greater symptom burden.

KW - Cancer

KW - Cancer-related fatigue

KW - Latent profile analysis

KW - Oncology

KW - Sleep disturbance

KW - Symptom cluster

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