TY - JOUR
T1 - Sleep disturbance, cytokines, and fatigue in women with ovarian cancer
AU - Clevenger, Lauren
AU - Schrepf, Andrew
AU - Christensen, Desire
AU - DeGeest, Koen
AU - Bender, David
AU - Ahmed, Amina
AU - Goodheart, Michael J.
AU - Penedo, Frank
AU - Lubaroff, David M.
AU - Sood, Anil K.
AU - Lutgendorf, Susan K.
N1 - Funding Information:
This research was funded in part by support from NIH Grants CA104825 and CA140933 to SL.
PY - 2012/10
Y1 - 2012/10
N2 - Pro-inflammatory cytokines, such as interleukin-6 (IL-6), have been implicated in the underlying processes contributing to sleep regulation and fatigue. Despite evidence for sleep difficulties, fatigue, and elevations in IL-6 among women with ovarian cancer, the association between these symptoms and IL-6 has not been investigated. To address this knowledge gap, we examined relationships between sleep disturbance, fatigue, and plasma IL-6 in 136 women with ovarian cancer prior to surgery. These relationships were also examined in 63 of these women who were disease-free and not receiving chemotherapy one year post-diagnosis. At both time-points, higher levels of IL-6 were significantly associated with sleep disturbances (p<0.05), controlling for potentially confounding biological and psychosocial covariates. Higher IL-6 was significantly associated with fatigue prior to surgery (p<0.05); however, when sleep disturbance was included in the model, the relationship was no longer significant. IL-6 was not significantly associated with fatigue at one year. Changes in sleep over time were significantly associated with percent change in IL-6 from pre-surgery to one year, adjusting for covariates (p<0.05). These findings support a direct association of IL-6 with sleep disturbances in this population, whereas the relationship between IL-6 and fatigue prior to surgery may be mediated by poor sleep. As this study is the first to examine cytokine contributions to sleep and fatigue in ovarian cancer, further research is warranted to clarify the role of biological correlates of sleep and fatigue in this population.
AB - Pro-inflammatory cytokines, such as interleukin-6 (IL-6), have been implicated in the underlying processes contributing to sleep regulation and fatigue. Despite evidence for sleep difficulties, fatigue, and elevations in IL-6 among women with ovarian cancer, the association between these symptoms and IL-6 has not been investigated. To address this knowledge gap, we examined relationships between sleep disturbance, fatigue, and plasma IL-6 in 136 women with ovarian cancer prior to surgery. These relationships were also examined in 63 of these women who were disease-free and not receiving chemotherapy one year post-diagnosis. At both time-points, higher levels of IL-6 were significantly associated with sleep disturbances (p<0.05), controlling for potentially confounding biological and psychosocial covariates. Higher IL-6 was significantly associated with fatigue prior to surgery (p<0.05); however, when sleep disturbance was included in the model, the relationship was no longer significant. IL-6 was not significantly associated with fatigue at one year. Changes in sleep over time were significantly associated with percent change in IL-6 from pre-surgery to one year, adjusting for covariates (p<0.05). These findings support a direct association of IL-6 with sleep disturbances in this population, whereas the relationship between IL-6 and fatigue prior to surgery may be mediated by poor sleep. As this study is the first to examine cytokine contributions to sleep and fatigue in ovarian cancer, further research is warranted to clarify the role of biological correlates of sleep and fatigue in this population.
KW - Cancer
KW - Circadian rhythm
KW - Fatigue
KW - Interleukin-6
KW - Ovarian cancer
KW - Sickness behaviors
KW - Sleep
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U2 - 10.1016/j.bbi.2012.04.003
DO - 10.1016/j.bbi.2012.04.003
M3 - Review article
C2 - 22543257
AN - SCOPUS:84865657274
SN - 0889-1591
VL - 26
SP - 1037
EP - 1044
JO - Brain, Behavior, and Immunity
JF - Brain, Behavior, and Immunity
IS - 7
ER -