title: Understanding sleep disturbances in African-American breast cancer survivors: a pilot study.
abstract: OBJECTIVE
  The goals of this study were (i) to report the prevalence and nature of sleep disturbances, as determined by clinically significant insomnia symptoms, in a sample of African-American breast cancer survivors; (ii) to assess the extent to which intrusive thoughts about breast cancer and fear of recurrence contributes to insomnia symptoms; and (iii) to assess the extent to which insomnia symptoms contribute to fatigue.
  
  
  METHODS
  African-American breast cancer survivors completed surveys pertaining to demographics, medical history, insomnia symptoms, and intrusive thoughts about breast cancer, fear of cancer recurrence, and fatigue. Hierarchical regression models were performed to investigate the degree to which intrusive thoughts and concerns of cancer recurrence accounted for the severity of insomnia symptoms and insomnia symptom severity's association with fatigue.
  
  
  RESULTS
  Forty-three percent of the sample was classified as having clinically significant sleep disturbances. The most commonly identified sleep complaints among participants were sleep maintenance, dissatisfaction with sleep, difficulty falling asleep, and early morning awakenings. Intrusive thoughts about breast cancer were a significant predictor of insomnia symptoms accounting for 12% of the variance in insomnia symptom severity. After adjusting for covariates, it was found that insomnia symptom severity was independently associated with fatigue accounting for 8% of variance.
  
  
  CONCLUSIONS
  A moderate proportion of African-American breast cancer survivors reported significant problems with sleep. Sleep disturbance was influenced by intrusive thoughts about breast cancer, and fatigue was associated with the severity of participants' insomnia symptoms. This study provides new information about sleep-related issues in African-American breast cancer survivors.
authors.affiliation: Howard University Cancer Center, Washington, DC, USA.
authors.forename: Teletia R
authors.initials: TR
authors.lastname: Taylor
authors.forename: Edward D
authors.initials: ED
authors.lastname: Huntley
authors.forename: Kepher
authors.initials: K
authors.lastname: Makambi
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sween
authors.forename: Lucile L
authors.initials: LL
authors.lastname: Adams-Campbell
authors.forename: Wayne
authors.initials: W
authors.lastname: Frederick
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Mellman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology*; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000523:psychology; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data