Sleep aid prescribing practices during neoadjuvant or adjuvant chemotherapy for breast cancer

Sleep disruption is a common complaint in breast cancer patients receiving chemotherapy. We describe the sleep aid prescribing practices of oncologists treating women receiving adjuvant or neoadjuvant chemotherapy for breast cancer at a single institution.

Subjects with early-stage breast cancer who received four cycles of neoadjuvant or adjuvant Adriamycin® and cyclophosphamide (AC) at the University of California, San Diego over a 2-year period were evaluated by retrospective chart review. Clinical data pertinent to sleep disorders and electronic prescriptions for sleep aids were collected using the electronic medical record.

Of the 124 breast cancer subjects, 52.4% discussed sleep with their provider. Whereas 13.7% of subjects reported prior sleep aid use, 32.3% were prescribed sleep aids during chemotherapy, most commonly lorazepam (31.4%) and zolpidem (29.4%). Women prescribed sleep aids during chemotherapy were significantly more likely to discuss sleep with their provider, more likely to have been taking sleep aids previously, and more likely to be taking psychiatric medications.

Sleep disturbances during AC chemotherapy for early-stage breast cancer are common and are frequently treated with sleep aid medications. We show that women with prior sleep aid use and concurrent psychiatric medication use were more likely to need sleep aids during chemotherapy, suggesting these are high-risk populations that could be targeted for intervention prospectively.