Prevalence, risk factors, and trajectories of sleep disturbance in a cohort of African-American breast cancer survivors

Brian D. Gonzalez, Sarah L. Eisel, Bo Qin, Adana A.M. Llanos, Josée Savard, Aasha I. Hoogland, Heather Jim, Yong Lin, Kitaw Demissie, Chi Chen Hong, Elisa V. Bandera

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Purpose: Sleep disturbance may be an overlooked modifiable risk factor for health disparities among African-American breast cancer survivors (AABCS). This study aimed to identify the prevalence of and risk factors for sleep disturbance in a cohort of AABCS. Methods: The study was conducted among participants in the Women’s Circle of Health Follow-up Study, a longitudinal study of breast cancer in 10 counties in New Jersey. Cases were identified shortly after diagnosis by the New Jersey State Cancer Registry. Self-reported sleep disturbance (Pittsburgh Sleep Quality Index) and other factors (e.g., socioeconomic status, menopausal status) were assessed at pre-diagnosis (n = 637), 10 months post-diagnosis (n = 261), and 24 months post-diagnosis (n = 632). Clinical data were obtained via medical record abstraction, and height and weight were measured by study staff. Results: Most AABCS (57%) reported clinically significant sleep disturbance before diagnosis, and this rate remained largely unchanged at 10 months (53%) and 24 months post-diagnosis (61%). Average sleep disturbance scores indicated clinically significant disturbance at all three assessments (M range = 6.67–7.57). Most reported sleeping fewer than the recommended 7 hours per night at each assessment (range 57–65%). Risk factors for sleep disturbance were identified at each assessment, including pre-diagnosis (less education), 10 months post-diagnosis (lack of insurance, treatment with chemotherapy), and 24 months post-diagnosis (younger age, less education, lower income, obesity, and lymphedema). Treatment with endocrine therapy was a protective factor at 10 months post-diagnosis. Conclusion: Most AABCS report clinically significant sleep disturbance from before diagnosis through 24 months post-diagnosis. These rates appear indicate AABCS experience significant sleep-related disparities.

Original languageEnglish (US)
Pages (from-to)2761-2770
Number of pages10
JournalSupportive Care in Cancer
Volume29
Issue number5
DOIs
StatePublished - May 2021

All Science Journal Classification (ASJC) codes

  • Oncology

Keywords

  • African-American or African-American cancer survivors
  • Breast neoplasms
  • Cancer
  • Oncology
  • Quality of life
  • Sleep
  • Survivorship

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