Sleep characteristics and recurrence in platinum-sensitive ovarian cancer survivors: A prospective cohort study

Objective

To describe characteristics of sleep (quality, duration, efficiency, and insomnia) in a cohort of high-grade epithelial ovarian cancer (EOC) survivors who have completed and responded to first-line chemotherapy, and to explore their relationships with disease recurrence.

Methods

In this cohort of 97 women, sleep and other factors were assessed at baseline and 4 months later. The distribution of participants by categories of sleep characteristics were calculated. Hazard ratios (HRs) and 95 % confidence intervals (95 % CI) for the association between each sleep characteristic and recurrence were estimated using the Cox proportional hazards model, and adjusted for confounding using propensity scores. Associations were estimated for all women and among those defined as fully platinum-sensitive.

Results

At baseline, just over half of participants (52.6 % to 56.7 %) had poor sleep quality, efficiency and duration, while most (62.9 %) did not experience insomnia. Distributions remained similar 4 months later. During follow-up, 47 recurrences occurred. Among all participants, HRs (95 % CIs) of recurrence were close to the value of 1, indicating no association, for sleep quality and efficiency, 1.22 (0.66–2.23) for not meeting vs. meeting sleep duration guidelines and 0.68 (0.34–1.39) for the presence vs. absence of insomnia. In fully platinum-sensitive women, the HRs (95 % CIs) were 1.50 (0.64–3.53) for not meeting duration guidelines, 1.25 (0.56–2.79) for poor sleep efficiency, 1.44 (0.55–3.72) for the presence of insomnia, and remained null for sleep quality.

Conclusion

Most EOC survivors have poor sleep quality, duration, and efficiency. Research with larger sample sizes is required to better understand the relationship between these sleep characteristics and the risk of recurrence.