title: Minority Breast Cancer Survivors: The Association between Race/Ethnicity, Objective Sleep Disturbances, and Physical and Psychological Symptoms.
abstract: Background. Limited research has been conducted on the moderating effect of race/ethnicity on objective sleep disturbances in breast cancer survivors (BCSs). Objective. To explore racial/ethnic differences in objective sleep disturbances among BCSs and their relationship with self-reported symptoms. Intervention/Methods. Sleep disturbance and symptoms were measured using actigraphy for 72 hours and self-reported questionnaires, respectively, among 79 BCSs. Analysis of covariance, Pearson's correlation, and multivariate regression were used to analyze data. Results. Sixty (75.9%) participants listed their ethnicity as white, non-Hispanic and 19 (24.1%) as minority. Total sleep time was 395.9 minutes for white BCSs compared to 330.4 minutes for minority BCSs. Significant correlations were seen between sleep onset latency (SOL) and depression, SOL and fatigue, and sleep efficiency (SE) and fatigue among minority BCSs. Among white BCSs, significant correlations were seen between SE and pain and wake after sleep onset (WASO) and pain. The association between depression and SOL and fatigue and SOL appeared to be stronger in minority BCSs than white BCSs. Conclusions. Results indicate that white BCSs slept longer than minority BCSs, and race/ethnicity modified the effect of depression and fatigue on SOL, respectively. Implications for Practice. As part of survivorship care, race/ethnicity should be included as an essential component of comprehensive symptom assessments.
authors.affiliation: Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Harvard Cancer Center, Boston, MA 02215, USA ; University of South Florida College of Nursing, Tampa, FL 33612, USA.
authors.forename: Pinky H
authors.initials: PH
authors.lastname: Budhrani
authors.affiliation: University of South Florida College of Nursing, Tampa, FL 33612, USA.
authors.forename: Cecile A
authors.initials: CA
authors.lastname: Lengacher
authors.affiliation: University of South Florida College of Nursing, Tampa, FL 33612, USA.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.affiliation: University of South Florida College of Nursing, Tampa, FL 33612, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Tofthagen
authors.affiliation: H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Jim
references.citation: Qual Life Res. 1998 May;7(4):301-10
references.pmid: 9610214
references.citation: J Clin Oncol. 2010 Jan 10;28(2):292-8
references.pmid: 19933917
references.citation: J Clin Nurs. 2005 Feb;14(2):204-11
references.pmid: 15669929
references.citation: Health Psychol. 2013 Aug;32(8):886-95
references.pmid: 23477582
references.citation: Psychooncology. 2006 Apr;15(4):306-20
references.pmid: 16041841
references.citation: Cancer. 2008 Dec 1;113(11):3222-30
references.pmid: 18973178
references.citation: Breast Cancer Res Treat. 2008 Mar;108(1):69-77
references.pmid: 17638071
references.citation: Biol Psychol. 2007 Apr;75(1):37-44
references.pmid: 17166646
references.citation: J Gerontol B Psychol Sci Soc Sci. 2015 Jul;70(4):568-75
references.pmid: 24285771
references.citation: J Clin Oncol. 2013 Sep 10;31(26):3233-41
references.pmid: 23940231
references.citation: J Behav Med. 2012 Feb;35(1):86-94
references.pmid: 21506018
references.citation: Breast. 2012 Apr;21(2):128-41
references.pmid: 22192715
references.citation: J Support Oncol. 2012 May-Jun;10(3):112-8
references.pmid: 22277573
references.citation: Cancer. 2011 May 1;117(9):1994-2003
references.pmid: 21509777
references.citation: Arch Intern Med. 2004 Feb 23;164(4):406-18
references.pmid: 14980992
references.citation: Sleep. 2007 Sep;30(9):1096-103
references.pmid: 17910381
references.citation: Drug Discov Today Dis Models. 2011 Winter;8(4):167-173
references.pmid: 22140397
references.citation: J Natl Cancer Inst Monogr. 2004;(32):93-7
references.pmid: 15263047
references.citation: J Pain Symptom Manage. 2010 Mar;39(3):535-47
references.pmid: 20083371
references.citation: Sleep Med Rev. 2013 Aug;17(4):255-62
references.pmid: 23348004
references.citation: Sleep. 2012 Feb 01;35(2):237-45
references.pmid: 22294814
references.citation: J Cancer Surviv. 2009 Dec;3(4):241-50
references.pmid: 19859813
references.citation: Genet Epidemiol. 2002 Mar;22(3):243-53
references.pmid: 11921084
references.citation: J Psychosoc Oncol. 2012;30(2):168-84
references.pmid: 22416954
references.citation: Sleep. 1982;5(4):389-99
references.pmid: 7163726
references.citation: J Pain Symptom Manage. 2009 Mar;37(3):352-62
references.pmid: 18723313
references.citation: Semin Oncol Nurs. 2007 May;23(2):127-35
references.pmid: 17512440
references.citation: Psychosom Med. 2008 May;70(4):410-6
references.pmid: 18480189
references.citation: Sleep. 2001 Aug 1;24(5):583-90
references.pmid: 11480655
references.citation: Support Care Cancer. 2012 Feb;20(2):357-65
references.pmid: 21311913
references.citation: Breast Cancer Res Treat. 2012 Aug;134(3):1291-5
references.pmid: 22752291
references.citation: Sleep Med. 2011 Mar;12(3):209-14
references.pmid: 21317037
references.citation: Palliat Support Care. 2015 Jun;13(3):575-81
references.pmid: 24524428
references.citation: Cancer Nurs. 2009 Sep-Oct;32(5):404-11
references.pmid: 19661794
references.citation: Epidemiology. 2008 Nov;19(6):838-45
references.pmid: 18854708
references.citation: J Adv Nurs. 2001 Mar;33(5):668-76
references.pmid: 11298204
references.citation: J Clin Sleep Med. 2009 Jun 15;5(3):263-76
references.pmid: 19960649
references.citation: Psychooncology. 2012 Aug;21(8):896-902
references.pmid: 21648016
references.citation: Int J Behav Med. 2012 Sep;19(3):280-7
references.pmid: 21915625
references.citation: J Natl Med Assoc. 2008 Mar;100(3):317-22
references.pmid: 18390025
references.citation: J Circadian Rhythms. 2011 May 18;9:4
references.pmid: 21592392
references.citation: Sleep. 2014 May 01;37(5):837-42
references.pmid: 24790261
references.citation: J Pain Symptom Manage. 2011 May;41(5):819-27
references.pmid: 21306864
references.citation: Am J Epidemiol. 2006 Jul 1;164(1):5-16
references.pmid: 16740591
references.citation: J Cancer Surviv. 2013 Sep;7(3):292-9
references.pmid: 23471730
references.citation: J Transcult Nurs. 2015 May;26(3):294-300
references.pmid: 24797252
references.citation: Oncol Nurs Forum. 2011 Jul;38(4):E314-25
references.pmid: 21708527
references.citation: Sleep. 2009 Sep;32(9):1155-60
references.pmid: 19750920
references.citation: Int J Cult Ment Health. 2013 Jan 1;6(1):58-71
references.pmid: 23682296
references.citation: Eur J Cancer. 2009 Feb;45(3):384-92
references.pmid: 18977131
references.citation: Sleep. 2010 Apr;33(4):467-74
references.pmid: 20394315
references.citation: Sleep. 2004 Dec 15;27(8):1567-96
references.pmid: 15683149