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VOLUME 36, ISSUE 10

ASSOCIATION BETWEEN SLEEP AND BREAST CANCER INCIDENCE IN POSTMENOPAUSAL WOMEN
Association between Sleep and Breast Cancer Incidence among Postmenopausal Women in the Women's Health Initiative

http://dx.doi.org/10.5665/sleep.3032

Emily Vogtmann, PhD, MPH1; Emily B. Levitan, SM, ScD1; Lauren Hale, MA, PhD2; James M. Shikany, DrPH3; Neomi A. Shah, MD, MPH4; Yohannes Endeshaw, MD5; Cora E. Lewis, MD, MSPH3; JoAnn E. Manson, MD, DrPH6; Rowan T. Chlebowski, MD, PhD7

1Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL; 2Department of Preventive Medicine, State University of New York School of Medicine, Stony Brook, NY; 3Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL; 4Department of Medicine, Albert Einstein College of Medicine of Yeshiva University, Montefiore Medical Center, Bronx, NY; 5Department of Aging and Geriatric Research, University of Florida, Gainesville, FL; 6Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; 7Los Angeles Biomedical Research Institute, Harbor-University of California at Los Angeles Medical Center, Torrance, CA



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Study Objectives:

To determine whether the duration of sleep, sleep quality, insomnia, or sleep disturbance was associated with incident breast cancer in the Women's Health Initiative (WHI).

Design:

Prospective cohort study.

Setting:

Women enrolled in one of the Clinical Trial (CT) arms or the Observational Study (OS) from the WHI conducted in the United States.

Participants:

This study included 110,011 women age 50 to 79 years with no history of cancer.

Measurements and Results:

Typical sleep duration, sleep quality, and other self-reported sleep measures over the past 4 weeks were assessed during the screening visits for both the CT and OS participants. The presence of insomnia and level of sleep disturbance was calculated from an index of the WHI Insomnia Rating Scale. The outcome for this study was primary, invasive breast cancer. A total of 5,149 incident cases of breast cancer were identified in this study. No statistically significant associations were found between sleep duration, sleep quality, insomnia, or level of sleep disturbance with the risk of breast cancer after multivariable adjustment. A positive trend was observed for increasing sleeping duration with the risk of estrogen receptor positive breast cancer, but the association estimates for each sleep duration category were weak and nonsignificant.

Conclusions:

This study does not provide strong support for an association between self-reported sleep duration, sleep quality, insomnia, or sleep disturbance with the risk of breast cancer.

Citation:

Vogtmann E; Levitan EB; Hale L; Shikany JM; Shah NA; Endeshaw Y; Lewis CE; Manson JE; Chlebowski RT. Association between sleep and breast cancer incidence among postmenopausal women in the Women's Health Initiative. SLEEP 2013;36(10):1437-1444.

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