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Sleep, Fatigue, and Depressive Symptoms in Breast Cancer Survivors and Matched Healthy Women Experiencing Hot Flashes

Janet S. Carpenter
Julie L. Elam
Sheila H. Ridner
Pam H. Carney
Gloria J. Cherry
Heather L. Cucullu
ONF 2004, 31(3), 591-598 DOI: 10.1188/04.ONF.591-598

Purposes/Objectives: To compare sleep quality and disturbance, fatigue, and depressive symptoms between breast cancer survivors and healthy women experiencing hot flashes and to examine relationships among sleep and remaining variables (fatigue, depressive symptoms, and frequency of hot flashes).

Design: Cross-sectional, descriptive, comparative pilot study.

Setting: University-based outpatient setting.

Sample: 15 breast cancer survivors and 15 healthy women matched on age, race, and menopausal status. All women had untreated hot flashes (no hormone replacement therapy or other hot flash treatments).

Methods: Questionnaires (sleep quality and disturbance, fatigue, and depression); two ambulatory, 24-hour sternal skin conductance monitoring sessions (hot flash frequency); and medical records review.

Main Research Variables: Sleep quality and disturbance, fatigue, depressive symptoms, and objective hot flash frequency.

Findings: The majority of participants evidenced poor sleep quality and high sleep disturbance (73% of breast cancer survivors and 67% of healthy women above a cutoff score of 5). Sleep duration was significantly shorter for breast cancer survivors in contrast to healthy women. Nighttime flashes were experienced by 67% of breast cancer survivors and 37% of healthy women. No group differences were found in fatigue, depressive symptoms, or objective hot flash frequency. Global sleep scores were significantly positively correlated with fatigue and depression but not with hot flash frequency.

Conclusions: Findings suggest that sleep disturbance is common in menopausal breast cancer survivors and healthy women, is not necessarily related to hot flashes, and may stem from a multifactorial etiology.

Implications for Nursing: Menopausal breast cancer survivors who present with any one of these symptoms should be screened for all symptoms both during and after treatment.

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