title: Polysomnographic Study of Sleep in Survivors of Breast Cancer.
abstract: OBJECTIVE
  Insomnia is a frequent complaint in breast cancer patients during and after treatment. Breast cancer survivors, 1-10 years posttreatment, underwent in-lab polysomnography (PSG) to objectively define the insomnia in those patients with such a complaint.
  
  
  METHODS
  Twenty-six breast cancer survivors (aged 39-80, mean 54.0 months posttreatment) spent 2 nights in the sleep laboratory. Sleep on Night 2 was scored for sleep stages, sleep onset latency, REM sleep onset latency, wake time, apneas and hypopneas, periodic limb movements and arousals. Subjects were allocated into 2 groups by their scores on the Pittsburgh Sleep Quality Index (PSQI): no/ mild sleep disturbance (PSQI score ≤ 9, n = 15) or moderate/ severe sleep disturbance (PSQI ≥ 10, n = 11).
  
  
  RESULTS
  Standard PSG/EEG parameters failed to differentiate insomniacs from non-insomniacs. The single variable that distinguished the insomnia group was periodic limb movements in sleep (PLMS). PLMS were significantly correlated (r ≅ 0.7, p < 0.02) with subjective report of insomnia on PSQI and insomnia severity index. Log[Number of PLMS] was higher in the moderate/severe insomnia group (p = 0.008). Five of 11 patients in the moderate/severe insomnia group had a PLMS index ≥ 15, compared to only one of 15 patients in the none/mild insomnia group (p = 0.02). Menopausal symptoms and use of caffeine, hypnotics, and antidepressants were unrelated to insomnia severity or PLMS.
  
  
  CONCLUSIONS
  PLMS was the sole PSG variable that separated breast cancer survivors with moderate/severe insomnia from those with no/mild sleep disturbance. Further study of the incidence and significance of PLMS in breast cancer survivors with the complaint of insomnia is merited.
authors.affiliation: National Sleep Research Institute, New York, NY.|Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Reinsel
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Tatiana D
authors.initials: TD
authors.lastname: Starr
authors.affiliation: The Rockefeller University Hospital, New York, NY.
authors.forename: Barbara
authors.initials: B
authors.lastname: O'Sullivan
authors.affiliation: Millennium Research Institute, San Diego, CA.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Passik
authors.affiliation: National Sleep Research Institute, New York, NY.|The Rockefeller University Hospital, New York, NY.|Department of Psychiatry, Columbia University Medical Center, New York, NY.
authors.forename: Neil B
authors.initials: NB
authors.lastname: Kavey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000175:diagnosis*; D017741:Survivors / Q000706:statistics & numerical data*
keywords: breast cancer; cancer survivors; insomnia; periodic limb movements in sleep; sleep