Sleep and health-related quality of life in women following a cancer diagnosis: results from the Women's Wellness after Cancer Program in Australia.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2022;30(12):10243-10253

Plain language summary

Women who have completed treatment for cancer experience physical and psychological sequelae that can negatively affect their quality of life (QoL) and health as they recover from treatment. The aim of this study was to examine the association between sleep problems and health related QoL. This study was a single-blinded, multi-centre randomised controlled trial. In total, 175 participants were randomised to the intervention group and 176 were randomised to the usual care (control) group. Results showed that: - sleep outcomes did not predict mental HRQoL after adjustment for covariates. - sleep duration did not predict physical or mental HRQoL after adjustment. - participants in the intervention group did not show greater long-term adherence to sleep recommendations (i.e. sleeping>7 h). Authors conclude that there was no significant effect of the intervention on the sleep duration outcome or any of the other sleep outcomes measured. Thus, opportunities to optimise and better target sleep interventions should continue to be explored in this population.

Abstract

PURPOSE Sleep disturbance after cancer treatment could compromise recovery. This paper examined the associations between post-treatment sleep problems and health-related quality of life (HRQoL), and the effectiveness of an e-enabled lifestyle intervention on sleep outcomes. METHODS The Women's Wellness after Cancer Program (WWACP) was examined in a single blinded, multi-centre randomised controlled trial. Data were collected from 351 women (Mage = 53.2, SD = 8.8; intervention n = 175, control group n = 176) who had completed surgery, chemotherapy and/or radiotherapy for breast, gynaecological or blood cancers within the previous 24 months. Participants completed the Pittsburgh Sleep Quality Index (PSQI) at baseline (prior to intervention randomisation), and at 12 and 24 weeks later. Sociodemographic information, menopausal symptoms (Greene Climacteric Scale) and HRQoL (36-Item Short Form Health Survey; SF-36) were also collected. Linear panel regression was used to examine the association between sleep variables and SF36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. A difference-in-difference regression model approach was used to examine the intervention effect on the sleep outcomes. RESULTS After adjustment for potential confounders, the sleep variables (except sleep duration) significantly predicted physical, but not mental, HRQoL. There was no statistically significant effect of the intervention on sleep outcomes at 12 or 24 weeks. CONCLUSION Women who have completed treatment for cancer experience sleep problems that are associated with decreased physical HRQoL. Improving sleep through targeted interventions should improve their physical HRQoL. Improved targeting of the sleep components of the WWACP should be explored.

Lifestyle medicine

Fundamental Clinical Imbalances : Neurological
Patient Centred Factors : Mediators/Sleep
Environmental Inputs : Mind and spirit
Personal Lifestyle Factors : Sleep and relaxation
Functional Laboratory Testing : Not applicable

Methodological quality

Jadad score : 3
Allocation concealment : Yes

Metadata

Nutrition Evidence keywords : Sleep