title: Feasibilty of a sleep intervention during adjuvant breast cancer chemotherapy.
abstract: OBJECTIVE
  To evaluate the feasibility of an intervention designed to promote sleep and modify fatigue during four cycles of adjuvant breast cancer chemotherapy.
  
  
  METHODS
  Prospective, repeated measures, quasi-experimental feasibility study.
  
  
  METHODS
  Midwestern urban oncology clinics.
  
  
  METHODS
  25 women between the ages of 40-65 (mean = 54.3) with stage I-II breast cancer receiving doxorubicin-based chemotherapy.
  
  
  METHODS
  Each woman developed, reinforced, and revised an individualized sleep promotion plan (ISPP) with four components: sleep hygiene, relaxation therapy, stimulus control, and sleep restriction techniques. A daily diary, the Pittsburgh Sleep Quality Index, a wrist actigraph, and the Piper Fatigue Scale were used to collect data two days before and seven days after each treatment.
  
  
  METHODS
  Adherence, sleep and wake outcomes, and fatigue.
  
  
  RESULTS
  Adherence rates with the components of the ISPP varied during treatments one through four: sleep hygiene (68%-78%), relaxation therapy (57%-67%), stimulus control (46%-67%), and sleep restriction (76%-80%). Mean sleep and wake outcomes at baseline, peak, and rebound times were that (a) sleep latency remained brief (less than 30 minutes per night), (b) time awake after sleep onset exceeded the desired less than 30 minutes per night, (c) sleep efficiency scores remained stable at 85%-90%, (d) total rest time remained stable at 8-10 hours per night, (e) subjective ratings of feelings on arising were stable, and (f) nighttime awakenings were 8-10 per night. Fatigue outcomes were that fatigue was stable two days after each treatment and mean daily fatigue intensity was lower at treatment three than at treatment one but rebounded at treatment four.
  
  
  CONCLUSIONS
  The intervention was feasible, adherence rates improved over time, and most sleep and wake patterns were consistent with normal values. Revisions will focus on decreasing nighttime awakenings.
  
  
  CONCLUSIONS
  Adopting behaviors to promote sleep may assist in maintaining sleep and managing fatigue during chemotherapy.
authors.affiliation: University of Nebraska Medical Center, Omaha, NE, USA. aberger@unmc.edu
authors.forename: Ann M
authors.initials: AM
authors.lastname: Berger
authors.forename: Susanna
authors.initials: S
authors.lastname: VonEssen
authors.forename: Brett R
authors.initials: BR
authors.lastname: Khun
authors.forename: Barbara F
authors.initials: BF
authors.lastname: Piper
authors.forename: Lynne
authors.initials: L
authors.lastname: Farr
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Agrawal
authors.forename: James C
authors.initials: JC
authors.lastname: Lynch
authors.forename: Patti
authors.initials: P
authors.lastname: Higginbotham
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000451:nursing*; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D004594:Electrophysiology / Q000379:methods; D005221:Fatigue / Q000188:drug therapy / Q000451:nursing / Q000473:pathology / Q000517:prevention & control; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010349:Patient Compliance / Q000706:statistics & numerical data; D011446:Prospective Studies; D012064:Relaxation Therapy; D012720:Severity of Illness Index; D012892:Sleep Deprivation / Q000188:drug therapy / Q000451:nursing / Q000473:pathology / Q000517:prevention & control*; D012894:Sleep Stages / Q000502:physiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014851:Wakefulness / Q000502:physiology