Objective and subjective sleep and cognitive dysfunction in women newly diagnosed with breast cancer

Wall, Kayla (2018) Objective and subjective sleep and cognitive dysfunction in women newly diagnosed with breast cancer. Masters thesis, Memorial University of Newfoundland.

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Abstract

Breast cancer is the most commonly diagnosed form of cancer in Canadian women. Cancer treatments such as endocrine therapy, radiation therapy, and chemotherapy are often associated with pervasive, negative side effects. One of the most prevalent barriers to resuming normal functioning following the completion of treatment is known as cancer-related cognitive dysfunction (CRCD). However, the factors that may influence the development of these cognitive impairments remain unclear. A potential underlying mechanism of CRCD that has not been well-studied is sleep quality. The present study sought to determine whether a patient’s sleep quality prior to treatment is indicative of cognitive functioning four months following the initiation of treatment in a sample of 32 women with breast cancer, using both subjective and objective measures. We found that all patients experienced worsened cognitive function, sleep, and mood disturbance at four months on subjective measures compared to baseline. Our findings may indicate that women with insomnia symptoms prior to diagnosis may begin treatment with poorer cognition and thus be at a higher risk for further cognitive deterioration. Moreover, women that do not exhibit symptoms of insomnia prior to beginning treatment may have a buffer against a decline in cognition. Participants with insomnia symptoms at baseline may also be at an increased risk for worsened mood disturbance as their treatment regimen proceeds. Future research should examine the changes in cognition, sleep, and mood disturbance with longer follow ups and investigate whether sleep quality mediates or moderates the relationship between cancer treatment and CRCD.

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