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The relative importance of specific risk factors for insomnia in women treated for early‐stage breast cancer
Author(s) -
Bardwell Wayne A.,
Profant Judith,
Casden Danielle R.,
Dimsdale Joel E.,
AncoliIsrael Sonia,
Natarajan Loki,
Rock Cheryl L.,
Pierce John P.
Publication year - 2008
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.1192
Subject(s) - psychosocial , breast cancer , medicine , insomnia , logistic regression , risk factor , population , cancer , clinical psychology , psychiatry , environmental health
Background : Many individual risk factors for insomnia have been identified for women with a history of breast cancer. We assessed the relative importance of a wide range of risk factors for insomnia in this population. Methods : Two thousand six hundred and forty‐five women ⩽4 years post‐treatment for Stage I (⩾1 cm)–IIIA breast cancer provided data on cancer‐related variables, personal characteristics, health behaviors, physical health/symptoms, psychosocial variables, and the Women's Health Initiative‐Insomnia Rating Scale (WHI‐IRS; scores ⩾9 indicate clinically significant insomnia). Results : Thirty‐nine per cent had elevated WHI‐IRS scores. In binary logistic regression, the variance in high/low insomnia group status accounted for by each risk factor category was: cancer‐specific variables, 0.4% (n.s.); personal characteristics, 0.9% (n.s.); health behaviors, 0.6% (n.s.); physical health/symptoms, 13.4% ( p <0.001); and, psychosocial factors, 11.4% ( p <0.001). Insomnia was associated with worse depressive (OR = 1.32) and vasomotor symptoms (particularly night sweats) (OR = 1.57). Conclusion : Various cancer‐specific, demographic, health behavior, physical health, and psychosocial factors have been previously reported as risk factors for insomnia in breast cancer. In our study (which was powered for simultaneous examination of a variety of variables), cancer‐specific, health behavior, and other patient variables were not significant risk factors when in the presence of physical health and psychosocial variables. Only worse depressive and vasomotor symptoms were meaningful predictors. Copyright © 2007 John Wiley & Sons, Ltd.