ORLANDO, FL—A large percentage of survivors of breast cancer with sleep complaints have symptoms suggesting underlying sleep disorders that require referral to a sleep medicine specialist for further evaluation and treatment, according to preliminary study evidence presented at the ONS 40th Annual Congress.

“Integration of basic screening questions in oncology clinic visits is needed to help delineate the problem and better triage those in need of referral,” said Julie Otte, PhD, RN, OCN®, of Indiana University School of Nursing in Indianapolis, Indiana.

“Up to 75% of breast cancer survivors experience long-term sleep problems. It is one of the top five severe and bothersome symptoms for survivors, and sleep complaints are complex,” explained Otte.

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She explained that when a survivor of breast cancer presents with a sleep complaint, determining if symptoms suggest the presence of an underlying sleep disorder, such as a specific insomnia disorder, sleep apnea, restless leg syndrome, periodic limb movements, or narcolepsy is difficult without a comprehensive evaluation. However, not all sleep complaints suggest such an underlying disorder.

Although often addressed in oncology follow-up visits, sleep complaints in the context of possible sleep disorders have not been formally studied, despite the need for this information to be able to provide optimal treatment.

Also important is understanding which survivors need further evaluation by a sleep specialist compared with those who could benefit from evidence-based, tailored cognitive behavioral treatments alone.

The researchers performed comprehensive evaluations of symptoms of poor sleep to delineate those symptoms suggesting presence of a sleep disorder in 38 postmenopausal survivors of breast cancer 1 year after completing treatment, including a structured interview and questionnaires.

Biomarker data were obtained from a convenience sample of survivors of breast cancer and analyzed using descriptive statistics and frequencies.

Mean age of the women was 58.7 years (SD 9.2); 47.7% were African American and 44.7% were white, non-Hispanic. Mean body mass index was 31.13 kg/m2 (SD 6.4).

“Only one woman had previously been seen by a sleep medicine specialist,” Otte reported.

Most of the women (97%) had symptoms suggesting a sleep disorder. The most common sleep disorders were insomnia  due to circadian rhythm (32 women [84.2%]), restless leg syndrome (23  women [60.5%]), and parasomnia (22 women [57.2%]). All but one woman had symptoms suggesting multiple sleep disorders.

This study was supported by funding from the Indiana University School of Nursing Center for Enhancing the Quality of Life in Chronic Illness.