Association between Pre-Existing Sleep Disorders and Survival Rates of Patients with Breast Cancer
by
, , and
Yen-Chang Chen
1,†
,
Wan-Ming Chen
2,†,
Ming-Feng Chiang
3,
Ben-Chang Shia
2,4,*
and
Szu-Yuan Wu
2,4,5,6,7,8,9,10,*
1
Division of Chest Medicine, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
2
Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 242062, Taiwan
3
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
4
Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei 242062, Taiwan
5
Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
6
Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
7
Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
8
Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
9
Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
10
Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this study.
Cancers 2022, 14(3), 798; https://doi.org/10.3390/cancers14030798
Submission received: 27 December 2021
/
Revised: 30 January 2022
/
Accepted: 2 February 2022
/
Published: 4 February 2022
(This article belongs to the Special Issue Psychosocial Oncology: Recent Advances and Challenges)
Simple Summary
This is the first study to estimate the effects of pre-existing sleep disorders on the survival outcomes of patients with breast cancer after receiving standard treatments. We conducted a head-to-head propensity score matching study to mimic a randomized trial to compare the survival rates of women with both sleep disorders and breast cancer. Women with pre-existing sleep disorders receiving curative treatments for breast cancer had poorer survival outcomes than those without sleep disorders. Therefore, patients should be screened and evaluated for pre-existing sleep disorders prior to breast surgery, with such disorders serving as survival predictors in patients with breast cancer. Future studies may investigate the survival benefits of pharmacological and behavioral treatments for sleep problems in patients with breast cancer.
Abstract
PURPOSE: To investigate the effects of pre-existing sleep disorders on the survival outcomes of women receiving standard treatments for breast invasive ductal carcinoma (IDC). METHODS: We recruited patients from the Taiwan Cancer Registry Database who had received surgery for clinical stage I–III breast IDC. The Cox proportional hazards model was used to analyze all-cause mortality. We categorized the patients into those with and without sleep disorders (Groups 1 and 2, respectively) through propensity score matching. RESULTS: In the multivariate Cox regression analysis, the adjusted hazard ratio for all-cause mortality for Group 1 compared with Group 2 was 1.51 (95% confidence interval: 1.19, 1.91; p < 0.001). CONCLUSION: Our study demonstrated that the sleep disorder group had poorer survival rates than the non-sleep disorder group in breast cancer. Therefore, patients should be screened and evaluated for pre-existing sleep disorders prior to breast surgery, with such disorders serving as a predictor of survival in patients with breast cancer. Future studies may investigate the survival benefits of pharmacological and behavioral treatments for sleep problems in patients with breast cancer.
Keywords:
breast cancer; invasive ductal carcinoma; sleep disorder; survival; risk factor
