title: Association of obesity and sleep problems among breast cancer survivors: results from a registry-based survey study.
abstract: OBJECTIVE
  Sleep-related complaints are common among breast cancer survivors. However, the risk factors underlying sleep disturbances in this population are not completely understood. Some studies have shown that maintaining normal weight can result in a reduced risk of cancer-related symptoms, including sleep problems; however, data from published studies are not consistent. This study examined the associations between body mass index (BMI) and sleep-related complaints in breast cancer survivors.
  
  
  METHODS
  Self-reported survey data from 861 breast cancer survivors at a single institution were analyzed. BMI was calculated based on self-reported weight and height at the time of the survey. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. Average sleep duration was calculated based on the reported hours of sleep on a typical weekday and weekend. Associations between BMI and the sleep outcomes were estimated using multivariable logistic regression.
  
  
  RESULTS
  In adjusted models, BMI was not significantly associated with either excessive daytime sleepiness or "short" sleep pattern (≤ 6 h) in our sample of breast cancer survivors. Younger age, presence of strong acute pain, and lower level of education were independent risk factors for excessive daytime sleepiness. African American race, presence of strong acute pain, and lower level of education were independent risk factors for being a short sleeper.
  
  
  CONCLUSIONS
  Findings from this study indicate that BMI is not independently associated with sleep-related outcomes among breast cancer survivors. More research is needed to identify cancer survivors who are at increased risk for sleep disturbances as well as the mechanisms that underlie such disturbances.
authors.affiliation: Department of Surgery, University of Maryland, Baltimore, MD, 21201, USA.|Department of Epidemiology and Public Health, University of Maryland, Baltimore, MD, 21201, USA.
authors.forename: Elena N
authors.initials: EN
authors.lastname: Klyushnenkova
authors.affiliation: The Baltimore Veterans Affairs Geriatric Research, Education and Clinical Center, Washington, DC, 20420, USA.|Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Maryland, Baltimore, MD, 21201, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Sorkin
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland, Baltimore, MD, 21201, USA. lgallic@mdmercy.com.|The Prevention and Research Center, Mercy Medical Center, 227 St. Paul Place, 6th Floor, Baltimore, MD, 21202, USA. lgallic@mdmercy.com.
authors.forename: Lisa
authors.initials: L
authors.lastname: Gallicchio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D012042:Registries; D012307:Risk Factors; D057566:Self Report; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology*; D017741:Survivors / Q000706:statistics & numerical data*
keywords: Body mass index; Breast cancer survivors; Epworth Sleepiness Scale; Sleep duration