Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 14.
doi: 10.1007/s11764-024-01649-5. Online ahead of print.

Uncovering the symptom relationship among sleep quality, anxiety, and depression in Chinese patients with breast cancer: multidimensional data validation using PSQI versus actigraphy

Yining Tao  1 , Qixi Liu  2 , Xinxin Ye  3 , Jie Feng  4   5 , Huanju Liu  6 , Jinqing Wu  7 , Jing Zhang  8 , Qian Lin  8 , Jingzhan Lu  9 , Renyang Liu  10
Affiliations

Uncovering the symptom relationship among sleep quality, anxiety, and depression in Chinese patients with breast cancer: multidimensional data validation using PSQI versus actigraphy

Yining Tao et al. J Cancer Surviv. .

Abstract

Purpose: The interplay between sleep quality, anxiety, and depression among breast cancer patients remains poorly understood. This study aimed to investigate and compare the symptoms relationships among these three factors in Chinese breast cancer patients, utilizing two sleep assessments.

Methods: Our study encompassed 288 participants diagnosed with breast cancer, from whom we collected demographic information through questionnaires. Sleep quality symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI) and wrist actigraphy, while anxiety and depression symptoms were measured using the Hospital Anxiety and Depression Scale (HADS). Network analyses were conducted using R to calculate the centrality (strength) and further identify central symptoms and bridge symptoms in two networks that differed by sleep assessments. Central symptoms are closely related to other symptoms, whereas bridge symptoms indicate that symptoms may increase spread risk between different conditions.

Results: In the network using PSQI data, "I have lost interest in my appearance" had the highest strength centrality (rs = 2.417), followed by "sleep duration" (rs = 1.068) and "sleep efficiency" (rs = 0.955). In the network using wrist actigraphy data, "wake after sleep onset" had the highest strength value (rs = 2.437), followed by "sleep efficiency" (rs = 2.397) and "sleep latency" (rs = 1.506). Two bridge symptoms were identified: "I feel cheerful" and "I look forward with enjoyment to things" in both networks.

Conclusions: Depressive symptoms played a leading role in the sleep-anxiety-depression network, underscoring the need for targeted intervention tailored to survivors' specific needs.

Implications for cancer survivors: Health workers can give priority to symptom-specific screening and therapies, incorporating psychological support into standard cancer care.

Keywords: Anxiety; Breast cancer; Depression; Network analysis; Sleep quality; Symptom assessment.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Winters S, et al. Breast cancer epidemiology, prevention, and screening. Prog Mol Biol Transl Sci. 2017;151:1-32.
    1. Sung H, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49.
    1. Nekhlyudov L, et al. Developing a quality of cancer survivorship care framework: implications for clinical care, research, and policy. J Natl Cancer Inst. 2019;111:1120–30.
    1. Harbeck N, et al. Breast cancer. Nat Rev Dis Primers. 2019;5:66. - PubMed - DOI
    1. Liu N, et al. Burden, trends, and risk factors for breast cancer in China from 1990 to 2019 and its predictions until 2034: an up-to-date overview and comparison with those in Japan and South Korea. BMC Cancer. 2022;22:826. - PubMed - PMC - DOI

LinkOut - more resources