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Sleep Quality and Fatigue after a Stress Management Intervention for Women with Early-Stage Breast Cancer in Southern Florida

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Abstract

Background

Sleep disruption and fatigue are ubiquitous among cancer patients and are sources of stress that may compromise treatment outcomes. Previously, we showed that a cognitive behavioral stress management (CBSM) intervention reduced anxiety and other stress-related processes in women undergoing primary treatment for breast cancer.

Purpose

This study examined secondary outcomes from a CBSM intervention trial for women with early-stage breast cancer to test if CBSM would improve sleep quality and fatigue among these patients at a single site in southern Florida. CBSM-related effects have already been demonstrated for indicators of psychosocial adaptation (e.g., general and cancer-related anxiety).

Methods

Patients were randomized to CBSM (n= 120) or a 1-day psychoeducation control group (n= 120). The Pittsburgh Sleep Quality Index (PSQI) and Fatigue Symptom Inventory were completed prior to randomization and 6 and 12 months after the baseline assignment.

Results

In latent growth analyses, women in CBSM reported greater improvements in PSQI sleep quality scores than controls, although there were no significant differences between conditions on PSQI total scores. Women in CBSM also reported greater reductions in fatigue-related daytime interference than controls, though there were no significant differences in changes in fatigue intensity. Changes in sleep quality were associated with changes in fatigue.

Conclusions

Future work may consider integrating sleep and fatigue content into stress management interventions for women with early-stage breast cancer.

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Acknowledgments

The project was supported by National Cancer Institute Research Grant CA-064710 (ClinicalTrials.gov Identifier: NCT01422551). We thank Drs. Robert P. Derhagopian, Sharlene Weiss, Alan S. Livingstone, Frederick L. Moffat, Jr., Jodeen E. Powell, Eli Avisar, Joyce Slingerland, Stefan Glück, Dido Franceschi, and the Dade County American Cancer Society for their help in recruiting participants. We thank Janny M. Rogriguez for her support with recruitment, study management, and data entry. We also thank the participants for sharing their time and experiences with us.

Conflict of Interest

Dr. Antoni reports that he received royalties from books and related training materials that he has authored on cognitive behavioral stress management intervention in health psychology. All other authors reported no financial interests or potential conflicts of interest.

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Authors and Affiliations

  1. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA, and The Miriam Hospital, Providence, RI, USA

    Sara Vargas

  2. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Michael H. Antoni, Charles S. Carver & Maria Llabre

  3. Sylvester Comprehensive Cancer Center, Miami, FL, USA

    Michael H. Antoni, Charles S. Carver, Suzanne C. Lechner, Maria Llabre, Bonnie B. Blomberg & Stefan Glück

  4. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    Suzanne C. Lechner

  5. Sleep Disorders Center, Miami VA Healthcare System, Miami, FL, USA

    William Wohlgemuth

  6. Department of Microbiology and Immunology, University of Miami, Miller School of Medicine, Miami, FL, USA

    Bonnie B. Blomberg

  7. Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

    Stefan Glück

  8. Baptist Health Breast Center, South Miami, FL, USA

    Robert P. DerHagopian

  9. Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro West, Suite 309, Providence, RI, 02906, USA

    Sara Vargas

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  1. Sara Vargas
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  2. Michael H. Antoni
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Correspondence to Sara Vargas.

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Vargas, S., Antoni, M.H., Carver, C.S. et al. Sleep Quality and Fatigue after a Stress Management Intervention for Women with Early-Stage Breast Cancer in Southern Florida. Int.J. Behav. Med. 21, 971–981 (2014). https://doi.org/10.1007/s12529-013-9374-2

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  • DOI: https://doi.org/10.1007/s12529-013-9374-2

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