Longitudinal Assessment of Sleep Disturbance and Systemic Inflammatory Responses in Breast Cancer Patients Undergoing Curative Treatment

Abstract

Sleep disturbances are frequently seen in people who have been diagnosed with breast cancer. Yet the connection between these sleep disturbances and systemic inflammatory responses or stress biomarkers during treatment is not fully understood. The present prospective, longitudinal case-control study was carried out to examine the associations between sleep disturbances (specifically insomnia) and haematological inflammatory indices, circulating inflammatory markers, stress hormones, and immune function. Initially, 218 participants were enrolled, consisting of 118 healthy controls and 100 women who had just been diagnosed with breast cancer. Following eligibility screening, the final study group included 104 participants: 40 healthy controls, 32 breast cancer patients without clinically significant insomnia (the non-insomnia group), and 32 breast cancer patients who did have insomnia (the insomnia group). Sleep disturbance was assessed using the Insomnia Severity Index (ISI), and haematological and inflammatory biomarkers were measured at three different times: before surgery, during treatment, and at the first follow-up. The results showed that patients with insomnia had a more marked inflammatory and stress-related biomarker pattern than those without insomnia and also than the healthy controls, although the size and significance of the differences varied at different clinical time points. The findings indicate a longitudinal association between insomnia and systemic inflammation in breast cancer patients and underline the need for further multicentre studies that include objective sleep assessments.