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. 2016 Apr 15;12(4):495-503.
doi: 10.5664/jcsm.5674.

Pre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival

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Free PMC article

Pre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival

Amanda I Phipps et al. J Clin Sleep Med. .
Free PMC article

Abstract

Study objectives: Poor sleep quality and short sleep duration have been associated with elevated risk for several cancer types; however, the relationship between sleep and cancer outcomes has not been well characterized. We assessed the association between pre-diagnostic sleep attributes and subsequent cancer survival within the Women's Health Initiative (WHI).

Methods: We identified WHI participants in whom a first primary invasive cancer had been diagnosed during follow-up (n = 21,230). Participants provided information on sleep characteristics at enrollment. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between these pre-diagnostic sleep characteristics and cancer-specific survival for all cancers combined and separately for common cancers. Analyses were adjusted for age, study arm, cancer site, marital status, income, smoking, physical activity, and time to diagnosis.

Results: No individual pre-diagnostic sleep characteristics were found to be significantly associated with cancer survival in analyses of all cancer sites combined; however, women who reported short sleep duration (≤ 6 h sleep/night) combined with frequent snoring (≥ 5 nights/w experienced significantly poorer cancer-specific survival than those who reported 7-8 h of sleep/night and no snoring (HR = 1.32, 95% CI: 1.14-1.54). Short sleep duration (HR = 1.46, 95% CI: 1.07-1.99) and frequent snoring (HR = 1.34, 95% CI: 0.98-1.85) were each associated with poorer breast cancer survival; those reporting short sleep combined with frequent snoring combined had substantially poorer breast cancer survival than those reporting neither (HR = 2.14, 95% CI: 1.47-3.13).

Conclusions: Short sleep duration combined with frequent snoring reported prior to cancer diagnosis may influence subsequent cancer survival, particularly breast cancer survival.

Keywords: cancer; sleep duration; snoring; survival.

Figures

Figure 1
Figure 1. Cause-specific survival in relation to typical sleep duration and survival among cancer case participants combined.
Solid black = never/rarely snore (< 5 nights/w); hatched black = frequent snorers (≥ 5 nights/w).
Figure 2
Figure 2. Cause-specific survival in relation to typical sleep duration and survival among women with breast cancer.
Solid black = never/rarely snore (< 5 nights/w); hatched black = frequent snorers (≥ 5 nights/w).
Figure 3
Figure 3. Cause-specific survival in relation to typical sleep duration and survival among women with lung cancer.
Solid black = never/rarely snore (< 5 nights/w); hatched black = frequent snorers (≥ 5 nights/w).

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