Sleep Difficulties Linked to Survival Among Women With Breast Cancer Interview with:

Claudia Trudel-Fitzgerald Ph.D. FRQS Postdoctoral research fellow & Clinical psychologist (OPQ) Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health Boston, MA 02115

Dr. Trudel-Fitzgerald

Claudia Trudel-Fitzgerald Ph.D. 
FRQS Postdoctoral research fellow & Clinical psychologist (OPQ)
Department of Social and Behavioral Sciences
Harvard T.H. Chan School of Public Health
Boston, MA 02115 What is the background for this study? What are the main findings?

Response: There is very limited research on the association between sleep characteristics and survival among individuals with cancer. However, this is an important question, especially among breast cancer patients because sleep disturbances are frequently reported by these women. Preliminary studies have suggested that sleep duration is related to mortality. The novel findings of our research indicate that not only sleep duration, but also changes in sleep duration before versus after diagnosis, as well as regular difficulties to fall or stay asleep, may also be associated with mortality among women with breast cancer over a period of up to 30 years. What should readers take away from your report?

Response: It is important that women with breast cancer who are unsatisfied with their sleep talk with a health professional to proceed to a deeper assessment. Our results also underline the importance of screening for sleep disturbances among breast cancer patients to identify those who experience extreme sleep duration, major changes before vs. after a cancer diagnosis, and regular sleep difficulties including wakefulness moments after sleep onset. There are several treatments available to improve sleep. For instance, prior studies have shown that cognitive-behavioral therapy is effective in improving sleep disturbances among cancer patients, in addition to positively impacts other areas of their life such as mood, fatigue, and daily functioning. What recommendations do you have for future research as a result of this study?

Response: In our study, we observed a significant association between various facets of sleep and mortality outcomes, even after taking into account many factors that may contribute to this association. For example, the role of sleep duration and sleep difficulties on mortality persisted despite statistical adjustment for variables such as age, education level, cancer stage & treatments, family history of breast cancer, snoring, weight, physical activity, depressive symptoms, and chronic conditions (diabetes and heart disease). Nonetheless, future research should aim to replicate these results while considering other factors like sleep apnea, fatigue, and light exposure. Furthermore, the role of sleep characteristics with survival among individuals diagnosed with other cancer sites is understudied thus far. 

Claudia Trudel-Fitzgerald, PhD, is a research fellow at the Department of Social and Behavioral Sciences at Harvard T.H. Chan School of Public Health (Boston, US), and a clinical psychologist at Ordre des Psychologues du Quebec (Quebec, Canada). This work has been supported by a fellowship to Dr. Trudel-Fitzgerald from the Canadian Institute of Health Research, and by technical support from the Channing Network of Medicine at Brigham and Women’s Hospital. Thank you for your contribution to the community.


Br J Cancer. 2017 Mar 30. doi: 10.1038/bjc.2017.85. [Epub ahead of print]

Sleep and survival among women with breast cancer: 30 years of follow-up within the Nurses’ Health Study.

Trudel-Fitzgerald C1, Zhou ES2,3, Poole EM4, Zhang X4,5, Michels KB6, Eliassen AH4,5, Chen WY2,3,4, Holmes MD4,5, Tworoger SS4,5, Schernhammer ES4,5,7.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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