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Relationship between sleep-related impairment and cognitive functioning among breast cancer survivors
Victoria M Telles1,2, Victoria Mac1, Rowena Tam1,2,3
1Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA.
Purpose:
Sleep-related impairment and cancer-related cognitive decline (CRCD) are common, disruptive symptoms affecting breast cancer survivors. This study examined the association between sleep-related impairment and both self-reported and objective cognitive functioning in breast cancer survivors following treatment.
Methods:
Participants (N = 253) from the I Can! Improving Cognition After Cancer study completed the NIH Toolbox Digit Symbol test to measure Processing Speed and a battery of neurocognitive tests of Memory, Executive Functioning, and Attention domains. Self-reported cognition was assessed with the PROMIS Cognitive Function and Abilities scales. Sleep-related impairment was measured by the PROMIS Sleep-Related Impairment scale. Multiple linear regression models were used to examine the associations between sleep-related impairment and the six cognitive outcomes, adjusting for demographic and cancer treatment factors.
Results:
Participants were on average 59 (SD = 8.9) years old, majority identified as White (77%) and were college graduates (42%). Fifty-seven percent of participants underwent chemotherapy, 80% received hormone therapy, and 81% were treated with radiation. Greater sleep-related impairment was significantly associated with worse executive function (β = -0.01, 95% CI: -0.022, -0.000, p = 0.04), worse cognitive abilities (β = -0.28, 95% CI: -0.375, -0.184, p < 0.001), and worse cognitive function (β = -0.25, 95% CI: -0.323, -0.167, p < 0.001). No significant associations were observed for memory, attention, or processing Speed.
Conclusion:
Greater sleep-related impairment was associated with poorer self-reported cognitive functioning and modest differences in executive functioning among breast cancer survivors, underscoring the importance of addressing sleep-related impairment in this population.
Implications For Cancer Survivors:
Assessing sleep-related impairment during survivorship care may help identify survivors experiencing cognitive difficulties and related daytime functional concerns.
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