Meta-Analysis of Changes in Sleep Quality of Women with Breast Cancer before and after Therapy

Wen Pei Chang, Yu Pei Chang

Research output: Contribution to journalReview articlepeer-review

16 Citations (Scopus)


Cancer treatments may affect the sleep quality and even future quality of life of women with breast cancer. A meta-analysis was performed to understand the changes in the sleep quality of women with breast cancer during their treatment period. In a systematic literature review in compliance with the PRISMA guidelines, we searched for articles published between 2000 and 2018 in databases. A total of 12 study articles were included. The standardized mean differences of the pooling effect size of sleep quality between the period before treatment and 1-8 weeks, 9-16 weeks, 17-24 weeks, and 25-56 weeks after the commencement of treatment were -0.020, -0.162, 0.075, and 0.216, respectively. Although the differences were not statistically significant, in view of the heterogeneity among the studies, we conducted further analysis using a linear mixed effect model. The overall results indicated poorer sleep quality as time passed from the start of the first treatment (p = 0.014). The results of this study revealed that patients experienced better sleep quality in the initial months after the beginning of treatment; however, their sleep quality became poorer between 4 months to approximately 1 year after the beginning of treatment, compared with the sleep quality before treatment, and continued to decline rather than improve during the follow-up period.

Original languageEnglish
Pages (from-to)227-235
Number of pages9
JournalBreast Care
Issue number3
Publication statusPublished - 2020


  • Cancer therapy
  • Meta-analysis
  • Sleep quality
  • Women with breast cancer

ASJC Scopus subject areas

  • Surgery
  • Oncology


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