Anita R Peoples1, Wilfred R Pigeon2, Dongmei Li3, Sheila N Garland4, Michael L Perlis5, Julia E Inglis6, Vincent Vinciguerra7, Thomas Anderson8, Lisa S Evans9, James L Wade10, Deborah J Ossip11, Gary R Morrow6, Julie Ryan Wolf12. 1. Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, New York, USA. Electronic address: anita.peoples@hci.utah.edu. 2. Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA. 3. Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, New York, USA. 4. Departments of Psychology and Oncology, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. 5. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA. 6. Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA. 7. Northwell Health NCORP, Lake Success, New York, USA. 8. Columbus NCORP, Columbus, Ohio, USA. 9. Southeast Clinical Oncology Research Consortium NCORP, Winston-Salem, North Carolina, USA. 10. Heartland Cancer Research NCORP, Decatur, Illinois, USA. 11. Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, New York, USA; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA. 12. Departments of Dermatology and Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA.
Abstract
CONTEXT: Pain can be a debilitating side effect of radiation therapy (RT). Data from the general population have shown that sleep disturbance can influence pain incidence and severity; however, less is known about this relationship in patients with breast cancer receiving RT. OBJECTIVES: This secondary analysis examined the association of pretreatment moderate/severe levels of sleep disturbance with subsequent RT-induced pain after adjusting for pre-RT pain. METHODS: We report on 573 female patients with breast cancer undergoing RT from a previously completed Phase II clinical trial for radiation dermatitis. Sleep disturbance, total pain, and pain subdomains-sensory pain, affective pain, and perceived pain intensity were assessed at pre-RT and post-RT. At pre-RT, patients were dichotomized into two groups: those with moderate/severe sleep disturbance (N = 85) vs. those with no/mild sleep disturbance (control; N = 488). RESULTS: At pre-RT, women with moderate/severe sleep disturbance were younger, less likely to be married, more likely to have had mastectomy and chemotherapy, and more likely to have depression/anxiety disorder and fatigue than the control group (all Ps < 0.05). Generalized estimating equations model, after controlling for pre-RT pain and other covariates (e.g., trial treatment condition and covariates that were significantly correlated with post-RT pain), showed that women with moderate/severe sleep disturbance at pre-RT vs. control group had significantly higher mean post-RT total pain as well as sensory, affective, and perceived pain (effect size = 0.62, 0.60, 0.69, and 0.52, respectively; all Ps < 0.05). CONCLUSION: These findings suggest that moderate/severe disturbed sleep before RT is associated with increased pain from pre-to-post-RT in patients with breast cancer.
CONTEXT: Pain can be a debilitating side effect of radiation therapy (RT). Data from the general population have shown that sleep disturbance can influence pain incidence and severity; however, less is known about this relationship in patients with breast cancer receiving RT. OBJECTIVES: This secondary analysis examined the association of pretreatment moderate/severe levels of sleep disturbance with subsequent RT-induced pain after adjusting for pre-RT pain. METHODS: We report on 573 female patients with breast cancer undergoing RT from a previously completed Phase II clinical trial for radiation dermatitis. Sleep disturbance, total pain, and pain subdomains-sensory pain, affective pain, and perceived pain intensity were assessed at pre-RT and post-RT. At pre-RT, patients were dichotomized into two groups: those with moderate/severe sleep disturbance (N = 85) vs. those with no/mild sleep disturbance (control; N = 488). RESULTS: At pre-RT, women with moderate/severe sleep disturbance were younger, less likely to be married, more likely to have had mastectomy and chemotherapy, and more likely to have depression/anxiety disorder and fatigue than the control group (all Ps < 0.05). Generalized estimating equations model, after controlling for pre-RT pain and other covariates (e.g., trial treatment condition and covariates that were significantly correlated with post-RT pain), showed that women with moderate/severe sleep disturbance at pre-RT vs. control group had significantly higher mean post-RT total pain as well as sensory, affective, and perceived pain (effect size = 0.62, 0.60, 0.69, and 0.52, respectively; all Ps < 0.05). CONCLUSION: These findings suggest that moderate/severe disturbed sleep before RT is associated with increased pain from pre-to-post-RT in patients with breast cancer.
Authors: Dan Lundstedt; Magnus Gustafsson; Gunnar Steineck; Per Malmström; David Alsadius; Agnetha Sundberg; Ulrica Wilderäng; Erik Holmberg; Karl-Axel Johansson; Per Karlsson Journal: Int J Radiat Oncol Biol Phys Date: 2011-11-11 Impact factor: 7.038
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Authors: Arianna Aldridge-Gerry; Jamie M Zeitzer; Oxana G Palesh; Booil Jo; Bita Nouriani; Eric Neri; David Spiegel Journal: Sleep Med Date: 2013-09-05 Impact factor: 3.492
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Authors: Christine Miaskowski; Bruce Cooper; Steven M Paul; Claudia West; Dale Langford; Jon D Levine; Gary Abrams; Deborah Hamolsky; Laura Dunn; Marylin Dodd; John Neuhaus; Christina Baggott; Anand Dhruva; Brian Schmidt; Janine Cataldo; John Merriman; Bradley E Aouizerat Journal: J Pain Date: 2012-12 Impact factor: 5.820
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Authors: Susan Grayson; Susan Sereika; Caroline Harpel; Emilia Diego; Jennifer G Steiman; Priscilla F McAuliffe; Susan Wesmiller Journal: Support Care Cancer Date: 2021-07-10 Impact factor: 3.603