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Subjective Sleep Quality, Objective Sleep Characteristics, Insomnia Symptom Severity, and Daytime Sleepiness in Women Aged 50 and Older With Nonmetastatic Breast Cancer

Carol A. Enderlin
Elizabeth Ann Coleman
Catherine Cole
Kathy C. Richards
Robert L. Kennedy
Julia A. Goodwin
Laura F. Hutchins
Karen Mack
ONF 2011, 38(4), E314-E325 DOI: 10.1188/11.ONF.E314-E325

Purpose/Objectives: To examine subjective sleep quality in women aged 50 and older as predicted by cancer status, age, number of comorbidities, and symptoms of depressed mood; and to describe objective sleep characteristics, insomnia symptom severity, and daytime sleepiness.

Design: Descriptive.

Setting: Urban university and private oncology clinics in the southern United States.

Sample: 32 women with and 35 without nonmetastatic breast cancer, aged 50-90 years (X = 64.9, SD = 4.67).

Methods: Two telephone interviews, the Pittsburgh Sleep Quality Index, Profile of Mood States, three days of home actigraphy, Insomnia Severity Index, Epworth Sleepiness Scale, and medical records review.

Main Research Variables: Subjective quality of sleep; secondary objectives were sleep characteristics, insomnia symptoms, and daytime sleepiness.

Findings: Poor subjective sleep quality was predicted by depressed mood (p < 0.00005). All mean objective sleep characteristics were similar for the breast cancer and comparison groups. Nocturnal awakenings were excessive (9.2 versus 7.3). Mean sleep onset latency was longer for the breast cancer group than for the comparison group (34.8 versus 15.6 minutes). Mean insomnia severity scores for the breast cancer group indicated subthreshold insomnia symptoms, and no clinically significant insomnia for the comparison group (8.9 versus 6.4). Mean daytime sleepiness scores were normal for both groups (7 versus 6).

Conclusions: Subjective sleep quality was predicted by depressed mood only. Sleep in the breast cancer group was characterized by poor sleep quality, frequent nocturnal awakenings, and insomnia symptoms.

Implications for Nursing: Screening and monitoring in women aged 50 and older with breast cancer may help promote early sleep intervention; however, additional collaborative research regarding the underlying causes of sleep disruption is needed.

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