According to Bower (2008), common behavioral symptoms among breast cancer patients are the disturbances in cognition, mood, energy and sleep.  The mentioned symptoms result in disruption of patients’ overall health and might persist for several years even after treatment. The study review four common behavioral symptoms related to breast cancer: sleep disturbance, fatigue, cognitive impairment, and depression. Using the qualitative research design, the study focuses on the mechanism, treatment and prevalence of the symptoms are described including recommendations for future research.

Paraskevi (2012) examines the quality of life that patients with breast cancer live after undergoing treatment. The article indicates that assessing cancer patients’ life after treatment can contribute to improved treatment. The article represents outcomes of quality life in breast cancer patients based on past descriptive findings. The findings are articulated using different headings. Using qualitative data, the researcher found out that depression, psychological distress, and insomnia was common among cancer patients. There is extensive research on quality of life of individuals suffering from breast cancer. The study has contributed significantly to improving breast cancer management and treatment.

According to Matthews, Arnedt, McCarthy, Cuddihy and Aloia (2013), one of the major health problems is chronic insomnia. Chronic insomnia affects about 10-15% of adults across the globe (Matthews, Arnedt, McCarthy, Cuddihy & Aloia, 2013).  The study evaluated 15 incidences on insomnia among breast cancer patients. The primary objective of the study was to synthesize the present study characteristics, adherence rates, methodology and contributing factors.  Inconsistency and strong patterns were identified in the studies, an aspect that complicates an evaluation on insomnia among breast cancer patients. However, the study is credible and well validated.

Otte, Carpenter, Manchanda, Rand, Skaar, Weaver and Landis (2015) state that sleep is essential for human functioning and sleep problems is common among cancer patients. The study reveals that it is still unclear whether sleep disorders among individuals with cancer is known. The research focuses on evaluating whether insomnia is related to breast cancer. The researchers collected data and entered them into an electronic database. This research is important for future studies in improving cancer treatment and management.

In the study, Naz, Khanum, Dal Sasso and de Souza (2016) not only examines but also analyses women’s experiences and their view of managing and handling their breast cancer. Seven women are drawn from Peshawar. They were diagnosed with breast cancer and were treated successfully. The researchers used a qualitative study, and the participants were interviewed.  The findings indicated that the women’s views on breast cancer were same compared to the rest of the population. The study concluded that there should be acceptable cultural programs for diagnosis.  This would assist in dealing with psychological problems such as insomnia.

Desai, Mao, Su, DeMichele, Li, Xie and Gehrman (2013) in the study examines the prevalence of insomnia and the effects of it in breast cancer. The researchers further indicate that there is little research on the prevalence of insomnia risk factors among women under aromatase inhibitors. The study used a cross-sectional survey and analyzed the data using the ANOVA analysis tool. The Results indicated that insomnia is highly linked to depression, age, hot flashes, joint pain and time of diagnosis (Desai, et al. 2013).

Bauml, Chen, Chen, Boyer, Kalos, Li and Mao (2015) argue that one of the common toxicity in women under aromatase inhibitors is arthralgia. Arthralgia can cause premature of the therapy, and women who take aromatase arthralgia. The researchers used a methodology, whereby all the women were taking aromatase inhibitors to complete Brief Pain Inventory. The study used a sample of 34 participants (Bauml, et al. 2015). Multivariate linear regression was used to evaluate the relationship between fatigue, insomnia and comorbid arthralgia using biomarker concentrations. The study concluded that among the participants taking aromatase inhibitors, the coexistence of insomnia, arthralgia, and fatigue reported increased inflammatory biomarkers levels.

According to the study by Fang, Miao, Chen, Sithole and Chung (2015), obstructive sleep, insomnia, and parasomnia have been linked to different diseases. However, there is minimal research on the relation between insomnia and cancer. The researchers investigated insomnia induced cancer. Fang, et al. (2015) used the nationwide population data for investigation purposes. The control group consisted of patients with and those without cancer. The risk factor in the study was exposure to sleep disorders. The findings showed that patients with insomnia are likely to develop breast cancer.

According to Mao, Armstrong, Bowman, Xie, Kadakia and Farrar (2007), studies among cancer populations have indicated that there is a variable symptomatic burden. However, there is minimal research on the pattern and extent among the U.S cancer population survivors, an aspect that is important for primary care physicians. To determine the prevalence of the continuous symptom burden, particularly among cancer survivors, a comparison was done with the rest of the population. The National Health Interview Survey provided data for this study. The data included 29, 092 controls and 1, 904 survivors. Major outcome results included insomnia, on-going pain, and psychological distress. The findings indicated that the rates of insomnia, on-going pain and psychological distress at 30%, 26%, and 34% (Mao, et al. 2007).

Aricò, Raggi and Ferri (2016) report that insomnia in patients diagnosed with breast cancer, and there is high frequency compared to general population. The problem remains understudied, and treatment is not taken seriously. In conducting the research, Aricò, Raggi & Ferri (2016) used peer reviewed journals. From the study, 16 studies critically evaluated CBT-1 effects in survivors of breast cancer. The research concluded that CBT-1 is an effective intervention for improving the quality of sleep in survivors of breast cancer.

References

Aricò, D., Raggi, A., & Ferri, R. (2016). Cognitive Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Review of the Literature. Frontiers in Psychology, 7(1162). 1-10.

Bauml, J., Chen, L., Chen, J., Boyer, J., Kalos, M., Li, S. Q., & Mao, J. J. (2015). Arthralgia among women taking aromatase inhibitors: is there a shared inflammatory mechanism with co-morbid fatigue and insomnia? Breast Cancer Research, 17(1), 89. Doi: 10.1186/s13058-015-0599-7

Bower, J. E. (2008). Behavioral symptoms in patients with breast cancer and survivors. Journal of Clinical Oncology, 26(5), 768-777.

Desai, K., Mao, J. J., Su, I., DeMichele, A., Li, Q., Xie, S. X., & Gehrman, P. R. (2013). Prevalence and risk factors for insomnia among breast cancer patients on aromatase inhibitors. Supportive Care in Cancer, 21(1), 43-51.

Fang, H. F., Miao, N. F., Chen, C. D., Sithole, T., & Chung, M. H. (2015). Risk of cancer in patients with insomnia, parasomnia, and obstructive sleep apnea: a nationwide nested case-control study. Journal of Cancer, 6(11), 1140-1147.

Matthews, E. E., Arnedt, J. T., McCarthy, M. S., Cuddihy, L. J., & Aloia, M. S. (2013). Adherence to cognitive behavioral therapy for insomnia: a systematic review. Sleep medicine reviews, 17(6), 453-464.

Mao, J. J., Armstrong, K., Bowman, M. A., Xie, S. X., Kadakia, R., & Farrar, J. T. (2007). Symptom burden among cancer survivors: impact of age and comorbidity. The Journal of the American Board of Family Medicine, 20(5), 434-443.

Naz, N., Khanum, S., Dal Sasso, G. T. M., & de Souza, M. D. L. (2016). Women’s Views on Handling and managing their breast cancer in Pakistan: A qualitative study. Diseases, 4(2), 17. Doi: 10.3390/diseases4020017

Otte, J. L., Carpenter, J. S., Manchanda, S., Rand, K. L., Skaar, T. C., Weaver, M., & Landis, C. (2015). Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained? Cancer medicine, 4(2), 183-200.

Paraskevi, T. (2012). Quality of life outcomes in patients with breast cancer. Oncology reviews, 6(1), 2-10.

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