Depression impairs sleep in breast cancer, but being married helps

By Lucy Piper, Senior medwireNews Reporter

Women with metastatic breast cancer are more likely to experience sleep disturbances if they are depressed or single, researchers report.

They believe that these women may have more to gain from clinical interventions than other women.

The team, led by Arianna Aldridge–Gerry (Stanford University School of Medicine, California, USA), used polysomnography measurements taken over three nights – two at home and one in the laboratory – to study the sleep architecture of 103 women with breast cancer, of whom 48 had high depressive symptoms and 44 were single.

Women with high depressive symptoms (score of at least 8 on the Center for Epidemiologic Studies Depression Scale) spent significantly more of their total sleep time in lighter stage 1 sleep (51.6 vs 43.0% for women with lower levels of depression) and less time in stage 2 sleep (34.3 vs 40.2%).

They also had significantly shorter rapid eye movement (REM) sleep than women with lower levels of depression, at 45.8 minutes versus 53.5 minutes, and spent a lower percentage of total sleep time in REM sleep, at 9.9% versus 11.6%.

Single women were lighter sleepers than their married peers, got fewer hours of sleep a night, awoke more during the night, and had poorer sleep efficiency.

The researchers note in Sleep Medicine that the greatest sleep quality impairments were seen in women who were depressed and single, but they found that marriage had a beneficial effect.

“Marriage seemed to protect sleep quality and normalize sleep architecture in the presence of depression, even when women slept alone in the laboratory,” they report.

This “suggests greater psychological effects of having a husband rather than physical effects on regulating sleep, especially among depressed women,” they add.

As sleep disturbances in depressed and single women with breast cancer may put them at increased risk for immune compromise, Aldridge–Gerry and co-workers call for further studies to investigate how these factors may relate to endocrine and immune function.

“These studies are central to identifying potential treatment methods that may improve depression, sleep, and other aspects of quality of life among women with breast cancer,” they conclude.

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