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2008年，世界睡眠医学会将每年春分前的星期五定为世界睡眠日。2019年3月15日世界睡眠日主题：健康睡眠，健康增寿。此外，中国睡眠研究会于2003年将每年3月21日定为中国的世界睡眠日。2019年中国的世界睡眠日主题：健康睡眠，益智护脑。 2019年3月，世界睡眠医学会《睡眠医学》在线发表中国香港中文大学、玛嘉烈医院、威尔斯亲王医院的研究报告，分析了辅助化疗对乳腺癌患者睡眠和褪黑素分泌的影响。 该前瞻队列研究于2015年5月～2016年12月入组早期乳腺癌术后辅助化疗患者180例，佩戴运动记录手环168小时，并在治疗前、化疗第一个周期和最后一个周期收集早晨首次尿样。将手环记录数据转换为睡眠持续时间、睡眠效率、夜间觉醒时间长短、节律比例、F值、幅度、中值、峰值，随后测定6-羟基黑色素硫酸盐的尿浓度。 结果，化疗第一个周期、最后一个周期与治疗前相比：
因此，该研究结果表明，化疗可以迅速干扰乳腺癌患者的睡眠质量和睡眠规律，而化疗结束时对睡眠质量和睡眠规律的影响较轻；不过，反复化疗引起夜间褪黑素分泌逐渐减少。 Sleep Med. 2019 Mar;55:14-21. Disruption of sleep, sleep-wake activity rhythm, and nocturnal melatonin production in breast cancer patients undergoing adjuvant chemotherapy: prospective cohort study. Li W, Kwok CC, Chan DC, Ho AW, Ho CS, Zhang J, Wing YK, Wang F, Tse LA. The Chinese University of Hong Kong, Hong Kong SAR, China; Monash University, Australia; Princess Margaret Hospital, Hong Kong SAR, China; Prince of Wales Hospital, Hong Kong SAR, China. HIGHLIGHTS
OBJECTIVE: This prospective cohort study captured the patterns of sleep, sleep-wake activity rhythm, and first-morning urinary melatonin in breast cancer patients undergoing adjuvant chemotherapy. METHODS: Breast cancer patients undergoing adjuvant chemotherapy wore wrist actigraph for 168 h and collected first-morning void urine samples before treatment, during the first, and at the last cycle of chemotherapy. We converted actigraphy data into sleep duration, sleep efficiency, nighttime total wake time, percent rhythm, F-statistic, amplitude, mesor, and acrophase. We then assessed urinary 6-sulfatoxymelatonin (aMT6s) levels. RESULTS: This cohort contained 180 participants. Compared with the baseline, sleep efficiency during the first and last cycle decreased by 10.16% [95% confidence interval (95% CI): 5.85%, 14.47%] and 5.01% (95% CI: 0.50%, 9.53%), respectively. Similarly, percent rhythm decreased by 27.20% (95% CI: 19.95%, 34.45%) during the first cycle and 21.20% (95% CI: 13.52, 28.89) during the last cycle. Taking the baseline as the reference, aMT6s levels during the first and last cycle decreased by 11.27% (95% CI: 0.37%, 22.16%) and 14.74% (95% CI: 2.34, 27.11), respectively. CONCLUSION: The first administration of adjuvant chemotherapy is associated with sleep disturbance and sleep-wake activity rhythm disruption among breast cancer patients, while the disturbance and disruption during the last cycle are less severe; nevertheless, repeated administration of chemotherapy results in progressive impairment of nocturnal melatonin production. KEYWORDS: Anti-cancer treatment; Breast cancer; Circadian rhythm; Melatonin; Sleep; Sleep-wake activity rhythm PMID: 30743205 DOI: 10.1016/j.sleep.2018.11.022
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