High Cortisol Levels As A Risk Factor For Poor Sleep Quality In Informal Caregiver Breast Cancer Patients At Sanglah Hospital Denpasar

Abstract Purpose Breast-cancer patients frequently report of poor sleep-quality. Although the pathophysiology is unclear, circadian-sleep misalignment is a plausible mechanism. We compared nocturnal melatonin-secretion, a circadian rhythm marker, in post-menopausal, post-treatment (≥12-months) female breast-cancer patients (BCG), with post-menopausal female controls with no history of cancer (CG) Methods We recruited 6 BCG and 10 CG from Westmead Hospital breast-cancer outpatient clinic or hospital-staff community, respectively. Participants completed the Pittsburgh Sleep Quality Index (PSQI; >5 PSQI-score=poor sleep-quality) and ~7 days of home-actigraphy (Philips Actiwatch-2, Philips Respironics, USA) to ascertain habitual bed-time (HBT). Later, participants completed an overnight, in-laboratory study, with saliva sampled (n=13) at regular intervals under strict dim-light conditions (<1 lux). Salivary-melatonin concentrations were quantified via radioimmunoassay (University of Adelaide). We measured 1) clock-time when salivary-melatonin concentrations reached 4pg/mL (melatonin onset-[DLMO-4pg/ml]) and 2) time-interval between HBT and DLMO-4pg/ml (indicates circadian-sleep misalignment-[PAR-DLMO]). Data were expressed as median [interquartile range], and compared using 2-sided Mann Whitney U-tests. p<0.05 was considered significant. Results BCG and CG had similar ages (62.5 [59.5–67.3] vs. 58.5 [54.0–66.3] yrs, respectively; p=0.23). Compared with CG, BCG had higher PSQI-scores (8.50 [5.25–10.75] vs. 4.00 [3.75–5.50] a.u.; p=0.07), but similar HBT (22:49 [21:46-23:38] vs. 22:17 [21:59-22:21] h:min; p=0.26). BCG had later DLMO-4pg/ml (20:46 [20:01-22:03] vs. 18:23 [17:55-20:07] h:min; p=0.03) and shorter PAR-DLMO (1.43 [0.96–2.38] vs. 3.63 [2.18–3.90] hrs; p=0.09), than CG. Conclusion Preliminary data indicate BCG had poorer sleep-quality, delayed melatonin onset, and altered circadian-sleep alignment; compared with CG. We speculate disrupted nocturnal melatonin-secretion potentially influences poor sleep-quality reported by breast-cancer patients.

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Factors Affecting Sleep Quality of Breast Cancer Patients with Chemotherapy

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5816 ◽

2021 ◽

Vol 9 (T4) ◽

pp. 130-136

Author(s):

Diyanah Syolihan Rinjani Putri ◽

Sri Nabawiyati Nurul Makiyah

Keyword(s):

Breast Cancer ◽

Sleep Quality ◽

Cancer Patients ◽

Nuclear Family ◽

Quality Data ◽

Physiological Status ◽

Poor Sleep ◽

Breast Cancer Patients ◽

Poor Sleep Quality ◽

Correlation Test

BACKGROUND: Poor sleep quality becomes the effect of chemotherapy in breast cancer patients. AIM: This study aimed to examine the factors that influence breast cancer patients’ sleep quality undergoing chemotherapy. METHODS: This research used an observational method with cross-sectional design. There were 26 breast cancer patients undergoing chemotherapy at Djojonegoro Regional Hospital in Temanggung, Central Java. The characteristics of the respondent are recorded, including the demographic characteristics, respondents’ sleep quality, and the physiological status data of the respondent. The researchers use the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality. Data were analyzed using Kendall’s Tau and Spearman’s rank correlation test and the Pearson Product-Moment Correlation test. RESULTS: The result showed that breast cancer patients’ sleep quality is classified as poor with PSQI score of 10.96 ± 3.13. The average age of the respondent was 50.08 ± 7.31 years. The major characteristic of the respondent were 80.77% had married, 42.30% had elementary education, 61.54% did not work, and 61.54% had Rp 0, - income. Based on breast cancer patients undergoing chemotherapy, the respondents lived in rice field environment (42.30%), diagnosed with breast cancer <1 year (69.23%), had <1 year chemotherapy (96.15%), had under mastectomy on the left breast (80.76%), and underwent chemotherapy as much as 7.23 ± 4.80 times. Based on sleep quality, the respondents lived with nuclear family (61.54%), had no comorbidities (76.92%), did not consume other drugs (100%), did not consume sleeping pills (80.76%), and used lights during sleep (65.38%). There is a correlation between sleep quality and age and with whom the respondent lives in the same house. CONCLUSION: It was concluded that breast cancer patients undergoing chemotherapy had poor sleep quality, and the factors related to sleep quality were age and with whom the respondent lived in the same house.

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Kualitas Tidur Pasien Kanker Payudara Berdasarkan Terapi yang Diberikan di RSUP DR. Hasan Sadikin Bandung

JURNAL PENDIDIKAN KEPERAWATAN INDONESIA ◽

10.17509/jpki.v3i2.9418 ◽

2017 ◽

Vol 3 (2) ◽

pp. 115

Author(s):

Devita Alifiyanti ◽

Yanti Hermayanti ◽

Dyah Setyorini

Keyword(s):

Breast Cancer ◽

Sleep Quality ◽

Cancer Patients ◽

Quality Index ◽

Pittsburgh Sleep Quality Index ◽

Sampling Technique ◽

Poor Sleep ◽

Breast Cancer Patients ◽

Consecutive Sampling

ABSTRAK Tidur berkualitas dibutuhkan oleh pasien kanker payudara agar kondisi dan daya tahan tubuh dapat dipertahankan optimal. Pada saat tidur sel yang rusak dapat diperbaiki. Perawat harus memfasilitasi kebutuhan tersebut dan harus mengetahui kualitas tidur pasien dengan terapi yang berbeda, sebagai dasar perencanaan asuhan. Penelitian ini bertujuan untuk meggambarkan kondisi kualitas tidur pasien yang sedang menjalankan terapi di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini menggunakan metode deskriptif kuantitatif dengan teknik consecutive sampling (n=31). Data dikumpulkan menggunakan kuesioner Pittsburgh Sleep Quality Index (PSQI). Kualitas tidur dikatakan baik bila skor total ≤ 5, dan kualitas tidur buruk bila skor total > 5. Hasil penelitian menunjukkan bahwa seluruh responden (100%) memiliki kualitas tidur yang buruk. Komponen yang paling banyak berkontribusi dalam penilaian tersebut adalah latensi tidur, durasi tidur, efisiensi kebiasaan tidur, dan disfungsi siang hari. Kualitas tidur terburuk dengan skor 18 terjadi pada responden yang menjalani radioterapi dengan mastektomi (2 orang) dan responden stadium lanjut (3 orang). Kesimpulan, bahwa terapi pengobatan yang dijalani dan kondisi kanker berkontribusi terhadap kualitas tidur pasien kanker payudara. Sejak pasien masuk perawat harus mengkaji kebutuhan tidur, menggali masalah kesulitan tidur, menjelaskan pengaruh tidur terhadap perbaikan sel, dan memberikan informasi tentang cara tidur berkualitas kepada pasien dan keluarganya untuk setting rumah sakit dan di rumah. Rumah Sakit harus memfasilitasi kebutuhan pasien agar tidak terganggu saat tertidur selama dalam perawatan. ABSTRACT Deep sleep is needed by breast cancer patients to maintain health quality optimally. During that time the damaged cells can be repair. Nurses should facilitate the need and should know the sleep quality as the basis for nursing care. This study aims to describe sleep quality of breast cancer patients with the treatmen at Dr. Hasan Sadikin Bandung. This research uses quantitative descriptive method with consecutive sampling technique (n = 31). Data were collected using the Pittsburgh Sleep Quality Index (PSQI). Sleep quality was good when the total score ≤5. Sleep quality was poor when the total score >5. The results show that all respondents (100%) had poor sleep quality. The components which contribute to the condition were sleep latency, sleep duration, sleep efficiency and daytime dysfunction. The worst score sleep quality was 18 which occurred on mastectomy patient with radiotherapy (2) and advanced stage patients (3). To conclude that treatment for cancer contribute to sleep quality of breast cancer patients. Nurses should assess the needs of sleep, explore the problem of sleeping difficulties, explain the effect of sleep on cell repair, and provide information about getting a good sleep at the hospital or home settings. Hospital should facilitate the infrastructure to full fill tne need.

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The Sleep Quality of Breast Cancer Patients

Journal of Nursing Care ◽

10.24198/jnc.v1i2.16140 ◽

2018 ◽

Vol 1 (2) ◽

Author(s):

Devita Alifiyanti ◽

Yanti Hermayanti ◽

Dyah Setyorini

Keyword(s):

Breast Cancer ◽

Sleep Quality ◽

Cancer Patients ◽

Sampling Technique ◽

The Body ◽

Poor Sleep ◽

Immune Functions ◽

Breast Cancer Patients ◽

Quality Of Sleep

The quality of sleep is required by breast cancer patients to regenerate and repair the body cells. When patients’ sleep is disturbed, it may be affected to the physiological conditions, such as decreased appetite, weight loss, anxiety, irritability, and changes in natural and cellular immune functions. Breast cancer therapies can affect the quality of sleep. This study aimed to determine the sleep quality of breast cancer patients that had treatments in a public hospital in Bandung. This research used the quantitative descriptive approach. The sample was selected using the consecutive sampling technique (n = 31). Data were collected using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Sleep quality was categorized as good when the total score was ≤ 5, and sleep quality was poor when the total score was > 5. The results of this study indicated that all respondents (100%) had poor sleep quality. The components that contributed to the assessment were sleep latency, sleep duration, sleep efficiency, and daytime dysfunction. The worst sleep quality with the highest score (18) occurred in respondents who had radiotherapy and mastectomy (2 persons), and respondents in advanced stage (3 persons). This study concludes that the pharmacological therapies and the stages of cancer contributed to the sleep quality of breast cancer patients. It is expected that health professionals and hospitals notice the patient’s sleeping needs during treatment at the hospital.

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KUALITAS TIDUR PASIEN KANKER PAYUDARA YANG MENJALANI KEMOTERAPI

Jurnal Ilmiah Kesehatan Keperawatan ◽

10.26753/jikk.v16i2.494 ◽

2020 ◽

Vol 16 (2) ◽

pp. 91

Author(s):

Dian Anggraini ◽

Dewi Marfuah ◽

Susy Puspasari

Keyword(s):

Breast Cancer ◽

Immune System ◽

Sleep Quality ◽

Cancer Patients ◽

Univariate Analysis ◽

Sampling Technique ◽

Poor Sleep ◽

Breast Cancer Patients ◽

The Impact

Background : In the last five years, the prevalence of breast cancer in Indonesia has increased. The usual treatment for breast cancer is chemotherapy, which can cause physical problems that affect sleep quality. Sleep disorders are often experienced by breast cancer patients, where the impact affects the healing of the cancer and the immune system so that the condition and immune system cannot be maintained optimally in repairing body cells. Purpose: to determine the quality of sleep in breast cancer patients undergoing chemotherapy and to see which components have contributed to disturbing sleep quality. Methods: The study used a quantitative descriptive approach. Sampling technique accidental sampling with 100 respondent. The questionnaire used to measure sleep quality was the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The data analysis technique used univariate analysis, there are two interpretations on the PSQI. Sleep quality is good if the score is ≤ 5, sleep quality is bad if the score is> 5. Results: Most of the respondents have poor sleep quality. This research is expected to increase the role of nursing care and educator so that it can improve the quality of life of breast cancer patients undergoing chemotherapy

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Chemotherapy-Induced Peripheral Neurotoxicity as A Risk Factor for Poor Sleep Quality in Breast Cancer Survivors Treated with Docetaxel

Asia-Pacific Journal of Oncology Nursing ◽

10.4103/apjon.apjon_51_20 ◽

2021 ◽

Vol 8 (1) ◽

pp. 68

Author(s):

Ya-Jung Wang ◽

Ya-Ning Chan ◽

You-Wun Jheng

Keyword(s):

Breast Cancer ◽

Risk Factor ◽

Sleep Quality ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Peripheral Neurotoxicity

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A Pilot Study: Application of Hemoglobin and Cortisol Levels, and A Memory Test to Evaluate the Quality of Life of Breast Cancer Patients on Chemotherapy

The International Journal of Biological Markers ◽

10.5301/jbm.5000053 ◽

2013 ◽

Vol 28 (4) ◽

pp. 348-356 ◽

Cited By ~ 1

Author(s):

Wings TY Loo ◽

Michael CW Yip ◽

Louis WC Chow ◽

Qing Liu ◽

Elizabeth LY Ng ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Patients ◽

Blood Cells ◽

Healthy Subjects ◽

Short Term Memory ◽

White Blood Cells ◽

Breast Cancer Patients ◽

Cortisol Levels

Background Short-term memory (STM) decline in breast cancer patients resulting from chemotherapy was evaluated by means of blood biomarkers, a questionnaire, and a computerized STM test. Methods This study was conducted from January 2013 to June 2013, recruiting 90 subjects: 30 breast cancer patients beginning the 3rd of 4th cycles of docetaxel and cyclophosphamide chemotherapy, 30 recovered patients (who completed 4 cycles of docetaxel for a minimum of 6 months), and 30 healthy subjects (disease-free females). The levels of hemoglobin, red and white blood cells, and cortisol in serum, and a computerized STM test were analyzed to estimate the effects of chemotherapy on STM. A questionnaire was given to all subjects to assess quality of life. Results Statistically significant differences were observed for the blood parameters (hemoglobin, red and white blood cells, and cortisol levels) between healthy and on-treatment subjects (respectively 13.47±0.96 g/dL vs 5.37±0.38 g/dL, 4.58±0.41 1012/L vs 2.07±0.13 1012/L, and 6.15±1.03 109/L vs 0.86±0.41 109/L). Scores of the STM test were significantly lower for patients compared to healthy subjects. As indicated by the results of the questionnaire, breast cancer patients had a higher tendency to forget than healthy controls (X2=3.15; p<0.0001) and recovered subjects (X2=3.15; p<0.0001). Conclusion We found depleted levels of hemoglobin, red and white blood cells as a result of chemotherapy, and elevated levels of stress correlated with poor performances in the computerized STM test. A higher cortisol level might be an important precursor of STM deterioration. Monitoring cortisol would be beneficial for evaluating the quality of life of breast cancer patients on chemotherapy.

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Effect of yoga on sleep quality and neuroendocrine immune response in metastatic breast cancer patients

Indian Journal of Palliative Care ◽

10.4103/ijpc.ijpc_102_17 ◽

2017 ◽

Vol 23 (3) ◽

pp. 253 ◽

Cited By ~ 12

Author(s):

RaghavendraMohan Rao ◽

HS Vadiraja ◽

R Nagaratna ◽

KS Gopinath ◽

Shekhar Patil ◽

...

Keyword(s):

Breast Cancer ◽

Immune Response ◽

Metastatic Breast Cancer ◽

Sleep Quality ◽

Cancer Patients ◽

Metastatic Breast ◽

Breast Cancer Patients

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PENGARUH LATIHAN JALAN KAKI TERHADAP KUALITAS TIDUR PADA PASIEN KANKER PAYUDARA YANG MENJALANI KEMOTERAPI DI RSUP DR. M DJAMIL PADANG

JURNAL KESEHATAN MERCUSUAR ◽

10.36984/jkm.v3i1.80 ◽

2020 ◽

Vol 3 (1) ◽

pp. Page16-27

Author(s):

Weny Amelia ◽

Mira Andika ◽

Diana Yulanda

Keyword(s):

Breast Cancer ◽

Sleep Quality ◽

Cancer Patients ◽

Quality Index ◽

Quality Score ◽

P Value ◽

Breast Cancer Patients ◽

Quality Of Sleep ◽

Walking Exercise

Abstrak Kemoterapi merupakan salah satu modalitas pengobatan kanker untuk mengatasi stadium lokal maupun metastase. Masalah yang sering muncul pada pasien kanker payudara yang menjalani kemoterapi adalah gangguan tidur sehingga berpengaruh terhadap kualitas tidur pasien. Penurunan kualitas tidur yang dialami oleh pasien kanker payudara yang menjalani kemoterapi dapat diatasi dengan latihan jalan kaki. Latihan jalan kaki merupakan kegiatan atau aktivitas yang dilakukan dengan menggunakan kedua kaki yang diikuti dengan ayunan tangan atau bagian anggota tubuh secara sinergis. Tujuan penelitian ini adalah untuk melihat pengaruh latihan jalan kaki terhadap kualitas tidur padapasien kanker payudara yang menjalani kemoterapi. . Penelitian ini dilakukan di RSUP Dr. M.Djamil Padang. Waktu penelitian ini dimulai pada tanggal 4-9 September 2019. Penelitian ini menggunakan pre eksperimet design dengan rancangan one group pretest-posttest design. Pengumpulan data dilakukan dengan menggunakan kuesioner PSQI (Pittsburgh Quality Index) untuk mengetahui kualitas tidur pasien berupa latihan jalan kaki selama 30 menit dilakukan 3 kali dalam 3 hari. . Hasil penelitian dengan uji statistik uji paired sampel t-test didapatkan bahwa rata-rata skor kualitas tidur sebelum intervensi 12.16 dan rata-rata skor kualitas tidur setelah intervensi 7.16. Penelitian ini menemukan perbedaan bermakna peningkatan kualitas tidur sebelum dan setelah intervensi p value = 0,000 ( p< 0.05) sehingga dapat disimpulkan bahwa terdapat pengaruh latihan jalan kaki terhadap kualitas tidur pasien kanker payudara yang menjalani kemoterapi. . Disarankan kepada perawat untuk memberikan edukasi latihan jalan kaki kepada pasien kanker payudara yang menjalani kemoterapi untuk meningkatkan kualitas tidur pasien, sehingga dapat meningkatkan kondisi kesehatan pasien secara umum yang nantinya dapat memperbaiki dan meningkatkan kualitas hidup pasien kanker payudara. Kata Kunci : Latihan Jalan kaki, Kualitas Tidur, Kanker Payudara, Kemoterapi Abstract Chemotherapy is one of the modalities of cancer treatment to overcome the local stage and metastasis. The problem that often arises in breast cancer patients undergoing chemotherapy is sleep disorders that affect the patient's sleep quality. Decreased sleep quality experienced by breast cancer patients undergoing chemotherapy can be overcome by walking exercises. Walking exercises are activities or activities carried out using both legs followed by swinging hands or parts of the body synergistically. The purpose of this study was to look at the effect of walking training on sleep quality in breast cancer patients undergoing chemotherapy. . This research was conducted at the Dr. M.Djamil Padang. When this study began on September 4-9, 2019. This study used a pre-experimental design with one group pretest-posttest design. Data collection was carried out using a PSQI (Pittsburgh Quality Index) questionnaire to determine the quality of sleep of patients in the form of 30 minutes of walking exercises performed 3 times in 3 days. . The results of the study with the statistical test paired sample t-test found that the average sleep quality score before the intervention was 12.16 and the average sleep quality score after the intervention was 7.16. This study found a significant difference in the improvement of sleep quality before and after the intervention p value = 0,000 (p <0.05) so that it can be concluded that there is an effect of walking exercise on the sleep quality of breast cancer patients undergoing chemotherapy. . It is recommended to nurses to provide education on walking exercises to breast cancer patients undergoing chemotherapy to improve the quality of sleep of patients, so as to improve the general health condition of patients who can later improve and improve the quality of life for breast cancer patients. Keywords: Breast Cancer, Chemotherapy, Sleep Quality, Walking Exercise

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