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Circadian Disturbances After Breast Cancer Surgery

Články mohou překládat pouze registrovaní uživatelé
Přihlášení Registrace
Odkaz je uložen do schránky
PostaveníDokončeno
Sponzoři
Melissa Voigt Hansen

Klíčová slova

Abstraktní

The purpose of this study is to investigate circadian disturbances after breast cancer surgery by means of monitoring sleep and heart-rate variability, by measuring a metabolite of melatonin in urine and by questionnaires and a sleep-diary.

Popis

An increasing number of studies have shown that circadian variation in the excretion of hormones, the sleep-wake cycle, the core body temperature, the tone of the autonomic nervous system and the activity rhythm are important both in health and disease processes. More attention is being paid towards the circadian variation in endogenous rhythms in relation to surgery and whether this can affect postoperative recovery, morbidity and mortality.

Studies have been done on circadian disturbances after major and minor surgery but never in relation to breast cancer surgery.

This study will investigate circadian disturbances in this specific group of patients by using Actigraphy, Polysomnography (PSG), Holter-monitoring (HRV), the primary metabolite of melatonin in urine 6-sulfatoxymelatonin (aMT6s), questionnaires and a sleep-diary.

Termíny

Poslední ověření: 02/28/2013
První předloženo: 07/25/2010
Odhadovaná registrace vložena: 07/26/2010
První zveřejnění: 07/27/2010
Poslední aktualizace byla odeslána: 03/06/2013
Poslední aktualizace zveřejněna: 03/07/2013
Aktuální datum zahájení studie: 01/31/2011
Odhadované datum dokončení primární: 10/31/2011
Odhadované datum dokončení studie: 10/31/2011

Stav nebo nemoc

Circadian Rhythm Disorders
Anxiety
Breast Cancer

Intervence / léčba

Device: Breast cancer patients

Device: Breast cancer patients

Device: Breast cancer patients

Procedure: Breast cancer patients

Other: Breast cancer patients

Other: Breast cancer patients

Other: Breast cancer patients

Fáze

-

Skupiny zbraní

PažeIntervence / léčba
Breast cancer patients
12 breast cancer patients aged 30-70 years undergoing a lumpectomy at Herlev Hospital. ASA score I-III.
Device: Breast cancer patients
Wrist-Actigraph to be worn on the non-dominant arm on day 0-3-17 of the study.

Kritéria způsobilosti

Věky způsobilé ke studiu 30 Years Na 30 Years
Pohlaví způsobilá ke studiuFemale
Metoda vzorkováníNon-Probability Sample
Přijímá zdravé dobrovolníkyAno
Kritéria

Inclusion Criteria:

- women, age 30-70, with breast cancer who are admitted for a lumpectomy at Herlev Hospital

- ASA score I-III

Exclusion Criteria:

- Known sleep apnea

- Pre-operative treatment with beta-blockers

- Diabetes Mellitus

- Known pre-operative depressive illness or dementia

- Previous or current cancer

- Known medically treated sleep-disorder (insomnia, restless legs etc)

- Shift-work

- Daily alcohol intake of more than 5 units

- Pre-operative treatment with psychopharmacological drugs, opioids or anxiolytics (including all sleeping pills)

- Predicted bad compliance

- Pregnant or breast-feeding

- Pre- or post-operative complications or events which are expected to increase morbidity or pain the first post-operative days.

- Missing written consent

- Pre-operative MMSE score less than 24

- Urine or fecal incontinence

Výsledek

Primární výsledná opatření

1. Preoperative sleep architecture of breast cancer patients [1 day preoperatively]

Sleep architecture measured by Polysomnography (awake, stadium I-IV, REM sleep, sleep latency, awakenings).

2. Postoperative sleep architecture of breast cancer patients (early phase) [The first postoperative night]

Sleep architecture measured by Polysomnography (awake, stadium I-IV, REM sleep, sleep latency, awakenings)

3. Postoperative sleep architecture of breast cancer patients (late phase) [The 14th postoperative night]

Sleep architecture measured by Polysomnography (awake, stadium I-IV, REM sleep, sleep latency, awakenings)

4. Sleep quality, fatigue, well-being and pain. [1 day preoperatively till 14 days postoperatively]

Fatigue, generel well-being, subjective sleep and pain scores on a Visual Analog Scale - questionnaires filled out daily. Sleepiness measured by Karolinska Sleepiness Scale. A sleep-diary recording sleep quantity of day and night sleep.

5. Preoperative melatonin levels and amplitude [1 day preoperatively]

Excretion of aMT6s in urine. Urine will be collected from 23-07, quantified and 2 samples will be taken to measure aMT6s.

6. Postoperative melatonin levels and amplitude (early phase) [The first postoperative night]

Excretion of aMT6s in urine. Urine will be collected from 23-07, quantified and 2 samples will be taken to measure aMT6s.

7. Postoperative melatonin levels and amplitude [The 14th postoperative night]

Excretion of aMT6s in urine. Urine will be collected from 23-07, quantified and 2 samples will be taken to measure aMT6s.

8. Sleep architecture [1 day preoperatively till 14 days postoperatively]

Actigraphy (total minutes asleep, sleep effectiveness, sleep latency, awakenings). A wrist actigraph wil be worn from 1 day preoperatively and taken off on the 14th postoperative day.

Měření sekundárních výsledků

1. Preoperative heart-rate variability of breast cancer patients [1 day preoperatively]

Heart-rate variability measured by Holter monitor and a following analysis of frequency domain parameters.

2. Postoperative heart-rate variability of breast cancer patients (early phase) [The first postoperative night]

Heart-rate variability measured by Holter monitor and a following analysis of frequency domain parameters.

3. Postoperative heart-rate variability of breast cancer patients (late phase) [The 14th postoperative night]

Heart-rate variability measured by Holter monitor and a following analysis of frequency domain parameters.

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