Sleeping quality, negative emotions and the awakening cortisol level in female breast cancer patients undergoing radiotherapy treatment

Abstract

Sleep disturbance is one of the common side effects experienced by cancer patients during treatment. Poor sleeping quality and sleepiness are not only affecting daily functioning of patients, it affects their immune system. In this study, we examined the sleeping quality of 156 Chinese breast cancer patients undergoing radiotherapy using the Chinese Pittsburg Sleep-Quality Index (C-PSQI), Participants were recruited from local hospital and community cancer support centers. Psychological distress was measured with Chinese Hospital Anxiety and Depression Scale (HADS) and Chinese Perceived Stress Scale (PSS). Morning saliva sample at awakening was also collected. Based on C-PSQI result, 65 % met or exceed the standard cut-off score for sleep problems (>5) and 51%reached the higher cut-off score (>=8). Participants with poor sleep quality also reported higher anxious and depressive emotions in the HADS(t=−5.22; p<.001) and higher stress level in PSS (t=−4.395; p<.001).Moreover, he mean awakening cortisol level of participants with better sleep quality is 9.68−6.25 nmol/l, while the participants with poor sleep quality mean awakening cortisol level is 8.57−4.69 nmol/l. Results suggest that poor sleep quality may relate to the psychological stress and negative emotions as well as Hypothalamic-Pituitary-Adrenal (HPA) axis functioning. Acknowledgement: This study is supported by the Research Grants Council General Research Fund (HKU745110H) and Hong Kong Cancer Fund. We would like to thanks staff in Queen Mary Hospital and Pamela Youde Nethersole Eastern Hospital for their assistance in this project.