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Breast Cancer Res Treat. 2017 Jul;164(1):169-178. doi: 10.1007/s10549-017-4245-1. Epub 2017 Apr 17.

Sleep quality, duration, and breast cancer aggressiveness.

Author information

1
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA.
2
Department of Family Medicine and Community Health, Case Western Reserve University, Cleveland, OH, USA.
3
Department of Epidemiology, University of Washington, Seattle, WA, USA.
4
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
5
Program in Public Health and Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA.
6
Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA.
7
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA. hmochs2@buffalo.edu.

Abstract

PURPOSE:

Epidemiological studies suggest that short sleep duration and poor sleep quality may increase breast cancer risk. However, whether sleep is associated with breast tumor aggressiveness characteristics has largely been unexplored.

METHODS:

The study included 4171 non-Hispanic whites (NHW) and 235 African Americans (AA) diagnosed with incident, primary, invasive breast cancer in the Women's Health Initiative (WHI) Observational Study (1994-2013). We used logistic regression to examine the association of baseline sleep (sleep duration, sleep quality, WHI Insomnia Rating Scale) with tumor grade, stage, hormone receptor status, HER2 status.

RESULTS:

In NHW, women who reported 6 h of sleep/night were more likely to have tumors classified as regional/distant stage at diagnosis compared to women who slept 7-8 h/night (adjusted odds ratio (OR): 1.25, 95% confidence interval (CI): 1.05-1.48). AA women who reported their typical night's sleep as 'average quality' or 'restless or very restless sleep' were more likely to be diagnosed with triple-negative tumors than those who reported 'sound or restful' sleep (adjusted ORs: 2.91 (1.11, 7.63) and 3.74 (1.10, 12.77), respectively).

CONCLUSIONS:

Our findings provide indications that aspects of sleep (sleep duration and quality), partially modifiable health behaviors, may be associated with development of aggressive tumor characteristics in postmenopausal women. The role of these sleep attributes may differ for NHW and AA women; however, further study in robust, racial diverse samples is needed. This study provides evidence that facets of sleep behavior are associated with the development of aggressive tumor features and these associations differ by race.

KEYWORDS:

Breast cancer; Disparities; Race; Sleep duration; Sleep quality; Subtype

PMID:
28417334
PMCID:
PMC5488283
DOI:
10.1007/s10549-017-4245-1
[Indexed for MEDLINE]
Free PMC Article

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