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Sleep disturbance and neurocognitive outcomes in older patients with breast cancer: Interaction with genotype.

ABSTRACT: BACKGROUND:Sleep disturbance and genetic profile are risks for cognitive decline in noncancer populations, yet their role in cancer-related cognitive problems remains understudied. This study examined whether sleep disturbance was associated with worse neurocognitive outcomes in breast cancer survivors and whether sleep effects on cognition varied by genotype. METHODS:Newly diagnosed female patients (n = 319) who were 60 years old or older and had stage 0 to III breast cancer were recruited from August 2010 to December 2015. Assessments were performed before systemic therapy and 12 and 24 months later. Neuropsychological testing measured attention, processing speed, executive function, learning, and memory; self-perceived cognitive functioning was also assessed. Sleep disturbance was defined by self-report of routine poor or restless sleep. Genotyping included APOE, BDNF, and COMT polymorphisms. Random effects fluctuation models tested associations of between-person and within-person differences in sleep, genotype, and sleep-genotype interactions and cognition and controlled for age, reading level, race, site, and treatment. RESULTS:One-third of the patients reported sleep disturbances at each time point. There was a sleep-APOE ?4 interaction (P = .001) in which patients with the APOE ?4 allele and sleep disturbances had significantly lower learning and memory scores than those who were APOE ?4-negative and without sleep disturbances. There was also a sleep disturbance-COMT genotype interaction (P = .02) in which COMT Val carriers with sleep disturbances had lower perceived cognition than noncarriers. CONCLUSIONS:Sleep disturbance was common and was associated with worse cognitive performance in older breast cancer survivors, especially those with a genetic risk for cognitive decline. Survivorship care should include sleep assessments and interventions to address sleep problems.

SUBMITTER: Carroll JE

PROVIDER: S-EPMC6891125 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Sleep disturbance and neurocognitive outcomes in older patients with breast cancer: Interaction with genotype.

Carroll Judith E JE Small Brent J BJ Tometich Danielle B DB Zhai Wanting W Zhou Xingtao X Luta George G Ahles Tim A TA Saykin Andrew J AJ Nudelman Kelly N H KNH Clapp Jonathan D JD Jim Heather S HS Jacobsen Paul B PB Hurria Arti A Graham Deena D McDonald Brenna C BC Denduluri Neelima N Extermann Martine M Isaacs Claudine C Dilawari Asma A AA Root James J Stern Robert A RA Mandelblatt Jeanne S JS

Cancer 20190925 24

<h4>Background</h4>Sleep disturbance and genetic profile are risks for cognitive decline in noncancer populations, yet their role in cancer-related cognitive problems remains understudied. This study examined whether sleep disturbance was associated with worse neurocognitive outcomes in breast cancer survivors and whether sleep effects on cognition varied by genotype.<h4>Methods</h4>Newly diagnosed female patients (n = 319) who were 60 years old or older and had stage 0 to III breast cancer were ...[more]

PMID: 31553501

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Project description:PurposeOur study was designed to examine the possible relationship between gut microbiota, sleep disturbances, and acute postoperative pain.MethodsUsing 16S rRNA sequencing, we analyzed preoperative fecal samples from women undergoing breast cancer surgery. Preoperative sleep disturbance was evaluated with the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Peak and average pain at rest and movement were evaluated 24 h after surgery, using a numerical rating scale (NRS). Preoperative symptoms of depression and anxiety were assessed with the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Inflammation was measured using white blood cell and neutrophil counts, together with platelet-lymphocyte ratio, and neutrophil-lymphocyte ratio.ResultsPreoperative sleep disturbance was associated with more severe acute postoperative pain. At the phylum level, women with poor sleep quality had higher relative abundance of Firmicutes (p = 0.021) and lower relative abundance of Bacteroidetes (p = 0.013). At the genus level, women with poor sleep quality harbored higher relative abundance of Acidaminococcus and lower relative abundance of several genera. The genus Alloprevotella was negatively associated with peak pain at movement during the first 24 h (r = - 0.592, p < 0.001). The genus Desulfovibrio was negatively associated with symptoms of anxiety (r = - 0.448, p = 0.006). However, partial correlations suggested that the relationship between Alloprevotella and peak pain at movement during the first 24 h was not statistically significant after controlling for sleep (r = - 0.134, p = 0.443).ConclusionThese findings suggest that the changed gut microbiota may be involved in sleep-pain interaction and could be applied as a potential preventive method for postoperative pain.Trial registrationThe present clinical study has been registered on Chinese Clinical Trial Registry ( www.chictr.org.cn ); the clinical trial registration number is ChiCTR1900021730; the date of registration is March 7, 2019.

Project description:BACKGROUND:The purpose was to prospectively examine the effects of sedentary behaviors on subjective memory impairment in breast cancer survivors (BCS) and the extent to which sleep disturbances mediated this pathway. METHODS:BCS (N = 380; Mage = 57.38 ± 9.25 years) completed questionnaires assessing demographics, health history, sitting behaviors, sleep disturbance, subjective memory impairment, and moderate-to-vigorous physical activity (MVPA) at baseline and 6-month follow-up. A subsample (N = 300) wore an accelerometer to objectively estimate sedentary time and MVPA. Structural equation modeling was used to test direct and indirect effects of self-reported and objectively estimated sedentary behaviors on memory impairment (through sleep disturbance) across time. Models were adjusted for demographic, clinical, and MVPA covariates. RESULTS:At baseline, more total daily sitting (? = 0.23), occupational sitting (? = 0.11), television viewing (? = 0.15), and computer use (? = 0.22) were associated with greater sleep disturbance, which was associated with greater memory impairment (? = -0.22). Indirect effects of self-reported sitting on memory were significant. At follow-up, increased total daily sitting (? = 0.08) and computer use (? = 0.14) predicted increased sleep disturbance, which predicted increased memory impairment (? = -0.09). The indirect path from increased computer use to memory impairment was significant (? = -0.01). In the accelerometer subsample, greater daily sedentary time at baseline was associated with less sleep disturbance (? = -0.14) and memory impairment (indirect effect: ? = 0.03). CONCLUSIONS:Findings provide early evidence that sedentary contexts may differentially influence sleep disturbance and memory impairment in BCS. Computer use and television viewing may pose the strongest risks to cognitive health. Disparate findings between objective and subjective sedentary measures warrant further research.

Dataset Information

Sleep disturbance and neurocognitive outcomes in older patients with breast cancer: Interaction with genotype.

Publications

Sleep disturbance and neurocognitive outcomes in older patients with breast cancer: Interaction with genotype.

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