A Prospective Study of Sleep Quality in Women Undergoing Chemotherapy for Breast, Ovarian, and Endometrial Cancer

Abstract

Abstract Purpose To describe changes and assess associations in sleep quality and quality of life (QOL) among chemotherapy naïve women undergoing treatment for breast, ovarian, or endometrial cancer Methods A prospective cohort study was performed in a Women’s Oncology Program. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and QOL using the Functional Assessment of Cancer Therapy (FACT) prior to-, halfway through-, at completion of-, and 6 months after chemotherapy. Patients with ovarian and endometrial cancers were combined into one group (GynCa) for analysis. The PSQI and FACT scores were analyzed using multivariable linear and logistic regression. Results Of the 102 eligible patients, 97 participants enrolled: breast (n=47), ovarian (n=27), and endometrial (n=23). Prior to starting chemotherapy, 59% of women reported poor sleep quality. By mid-treatment, both groups experienced worsening sleep quality: breast (p=.05) and GynCa (p=.04), and QOL: breast (p=0.0001) and GynCa (p=0.02). Changes in sleep quality did not persist at treatment completion. A significant QOL improvement was reported among GynCa patients compared to the breast cohort at 6-months post-treatment (p=0.047). Poorer sleep quality was associated with lower QOL at most study time points. Conclusions The majority of chemotherapy naïve women reported poor sleep at baseline. By treatment completion, average PSQI scores continued to show clinically significant sleep disturbances. Poor sleep quality is associated with lower QOL, a prognostic indicator for survival. Future work should examine whether disturbed sleep during chemotherapy worsens treatment outcomes. Poor sleep may be a novel therapeutic target in this population