Evaluation of sleep pattern disorders in breast cancer patients receiving adjuvant treatment (chemotherapy and/or radiotherapy) using polysomnography

Purpose: To assess sleep disturbance patterns in breast cancer patients receiving adjuvant radiotherapy and/or chemotherapy in comparison to normal subjects, and their impact on quality of life. Methods: Seventy-four histologically proven breast cancer patients of both genders, aged 30 to 65 years, were classified into 2 groups. First group: 26 patients with breast cancer before receiving any treatment. Second group: 48 breast cancer patients, subdivided into group A (24 patients with adjuvant chemotherapy), and group B (24 patients with adjuvant radiotherapy). A control group consisted of 24 healthy individuals matched in age and sex with patient groups. Clinical assessment of sleep was done using the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and one night Polysomnography (NPSG). Results: No statistically significant difference regarding age and sex was found compared to control group. The severity of insomnia (ISI) was 29.2%, 4.2%, 7.7% and 0% for patients who received chemotherapy and/or radiotherapy, and comparison of patients without treatment and the control group showed statistical significance. Excessive daytime sleepiness was 37.5%, 25%, 26.9% and 0% for patients who received chemotherapy and/or radiotherapy, before receiving treatment, and the control groups respectively, the difference been significant. Comparison of patients who received treatment with those who did not and the control groups showed significant shortening of total sleep time, decrease of sleep efficiency and lengthening of sleep latency. Significant lengthening in stage 2 of non-rapid eye movement (NREM), while insignificant lengthening in stages 1, 3 and 4 of NREM sleep was noted. Significant reduction of rapid eye movement (REM) and total sleep time percentage were observed. Sleep apnea was insignificantly more common in breast cancer patients compared to healthy controls. Conclusion: Sleep-related changes in breast cancer patients should be used in planning best supportive care.