title: A nested case-controlled comparison of telomere length and psychological functioning in breast cancer survivors with and without insomnia symptoms.
abstract: The ability to achieve sufficient restorative sleep is important in the maintenance of physical and mental health; however, disturbed sleep and insomnia symptoms are a common experience among women with breast cancer. In non-cancer populations, insufficient sleep quantity and quality has been associated with shortened telomere length (TL), a measure of accumulated cellular damage and human aging. This feasibility study compared TL in women previously diagnosed with breast cancer with clinically significant insomnia symptoms (n=70) to an age- and body mass index (BMI)-matched comparison group (n=70) of breast cancer survivors. Women with significant insomnia symptoms had higher levels of unemployment compared to women without insomnia. TL was positively skewed and shorter in the insomnia group (Median=6.000, S=1.000, standard error [SE]=0.287) than the control group (Median=6.195, S=-0.269, SE=0.287); however, this was not significant (p=0.29). Women with insomnia also reported significantly higher levels of depression (p<0.001), anxiety (p<0.001), and fatigue (p<0.001). This study provides the first measure of effect size and variability of TL in women with breast cancer and highlights the need for larger sample sizes to investigate the impact of insomnia and co-morbid symptom distress on cellular aging.
authors.affiliation: 1 Department of Family Medicine and Community Health, University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Sheila N
authors.initials: SN
authors.lastname: Garland
authors.forename: Christina
authors.initials: C
authors.lastname: Palmer
authors.forename: Michelle
authors.initials: M
authors.lastname: Donelson
authors.forename: Philip
authors.initials: P
authors.lastname: Gehrman
authors.forename: F Brad
authors.initials: FB
authors.lastname: Johnson
authors.forename: Jun J
authors.initials: JJ
authors.lastname: Mao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000150:complications; D001943:Breast Neoplasms / Q000150:complications* / Q000523:psychology*; D016022:Case-Control Studies; D003710:Demography; D003863:Depression / Q000150:complications; D005221:Fatigue / Q000150:complications; D005260:Female; D006801:Humans; D008875:Middle Aged; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D059505:Telomere Homeostasis
references.citation: Prog Neuropsychopharmacol Biol Psychiatry. 2012 Jun 1;37(2):247-51
references.pmid: 22401887
references.citation: Mech Ageing Dev. 2009 Nov-Dec;130(11-12):784-92
references.pmid: 19896964
references.citation: Support Care Cancer. 2010 Jan;18(1):105-14
references.pmid: 19381692
references.citation: Brain Behav Immun. 2012 Jul;26(5):706-13
references.pmid: 22406004
references.citation: J Psychosom Res. 2002 Feb;52(2):69-77
references.pmid: 11832252
references.citation: J Aging Res. 2011;2011:721390
references.pmid: 22046530
references.citation: Sleep. 2004 Mar 15;27(2):285-91
references.pmid: 15124724
references.citation: Sleep Med Rev. 2006 Dec;10(6):419-29
references.pmid: 16963293
references.citation: Cancer Prev Res (Phila). 2012 Oct;5(10):1173-82
references.pmid: 22827974
references.citation: Gerontology. 2010;56(4):390-403
references.pmid: 20016137
references.citation: Psychooncology. 2005 Jun;14(6):429-41
references.pmid: 15376284
references.citation: Cancer. 1999 Mar 1;85(5):1186-96
references.pmid: 10091805
references.citation: J Clin Oncol. 2014 Feb 10;32(5):449-57
references.pmid: 24395850
references.citation: PLoS One. 2011;6(8):e23462
references.pmid: 21853136
references.citation: Ann Behav Med. 2012 Aug;44(1):10-20
references.pmid: 22450856
references.citation: PLoS One. 2012;7(10):e47292
references.pmid: 23144701
references.citation: Neurol Clin. 2012 Nov;30(4):1313-43
references.pmid: 23099140
references.citation: Biol Psychiatry. 2008 Sep 15;64(6):538-40
references.pmid: 18561896
references.citation: Brain Behav Immun. 2012 May;26(4):573-9
references.pmid: 22293459