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

Shannon L Edmed, M Mamun Huda, Simon S Smith, Charrlotte Seib, Janine Porter-Steele, Debra Anderson, Alexandra L McCarthy

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

PMID: 36350379

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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 (M = 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.

Address: Institute for Social Science Research, The University of Queensland, 80 Meiers Rd, Indooroopilly, Brisbane, 4068, Australia. [email protected].; ARC Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, Brisbane, Australia. [email protected].; Institute for Social Science Research, The University of Queensland, 80 Meiers Rd, Indooroopilly, Brisbane, 4068, Australia.; ARC Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, Brisbane, Australia.; ARC Centre of Excellence for the Digital Child, The University of Queensland, Brisbane, Australia.; School of Nursing and Midwifery, Griffith University, Southport Queensland, 4215, Australia.; The Wesley Hospital Choices Cancer Support Centre, Brisbane, Australia.; School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.; Faculty of Health, University of Technology Sydney, New South Wales, Australia.; Mater Research Institute, Brisbane, QLD, Australia.

DOI: 10.1007/s00520-022-07429-0