Sleep disturbance, cytokines, and fatigue in women with ovarian cancer.
Abstract
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 1 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 1 year. Changes in sleep over time were
significantly associated with percent change in IL-6 from pre-surgery to
1 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.
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