Sensor based sleep patterns and reported sleep quality in breast cancer patients undergoing neoadjuvant chemotherapy

Breast cancer is the most diagnosed cancer in women worldwide and its treatment often leads to the onset of sleep disturbances. While much research has focused on chemotherapy’s impact on overall sleep quality through subjective measures, less attention has been given to its effects on specific sleep metrics such as duration, timing, continuity, and naps. This preliminary study addresses this gap by assessing sleep duration, timing, and regularity, using the Emfit QS device over 100 consecutive days in 24 breast cancer patients undergoing neoadjuvant chemotherapy. Additionally, we incorporated the Pittsburgh Sleep Quality Index (PSQI) to measure reported sleep quality. Our results suggest that chemotherapy may influence the duration for time spent in bed (ptrend=0.02) measured by the Emfit QS. Duration in bed decreased over the first seven weeks (e.g., 9.3 h/day at week 1 vs. 8.5 h/day at week 8), and increased thereafter to similar amounts as those recorded in week 1 (9.0 h/day at week 15). Sleep timing and regularity, also measured by the Emfit QS, remained unchanged. Overall sleep quality, as measured by the PSQI, did not change over time. However, our analysis of the individual components of the PSQI revealed that sleep disturbances increased as treatment progressed from week 1 to week 8 (1.3 ± 0.6 to 1.7 ± 0.6; p=0.01), concurrently with an increase in insomnia symptoms. Approximately, 33%, 63%, and 73% reported having insomnia symptoms at week 1, 8, and 15. These findings highlight critical periods during treatment when patients are vulnerable to disrupted sleep. Future research should focus on interventions to mitigate sleep disturbances, improving patient wellbeing and overall quality of life.