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The Association Between Sleep Disturbance and Proinflammatory Markers in Patients With Cancer: A Meta-analysis.

Background
Sleep disturbance is one of the symptoms with high incidence and negative influence in patients with cancer. A better understanding of the biological factors associated with sleep disturbance is critical to predict, treat, and manage this condition.


Objective
The aim of this study was to determine the correlation between sleep disturbance and proinflammatory markers in adult patients with cancer.


Methods
A systematic search was conducted in 7 databases from inception to March 1, 2020, for this meta-analysis. Two reviewers independently screened the studies, extracted data, and appraised the quality of the studies. Meta-analyses were conducted using Stata 12.0 software.


Results
Sixteen studies were included. Results indicated that sleep disturbance was associated with higher levels of the overall proinflammatory markers and that the effect size was small yet significant. Further subgroup analyses suggested that sleep disturbance was significantly associated with interleukin-6 and C-reactive protein, but not with interleukin-1[beta] or tumor necrosis factor-[alpha]. Meta-regression results indicated that only the sample source affected the association between sleep disturbance and proinflammatory markers.


Conclusion
There was a positive relationship between sleep disturbance and selected proinflammatory markers in adult patients with cancer.


Implication for Practice
This review provides empirical support for the association between sleep disturbance and certain proinflammatory markers. Healthcare providers can further explore specific biomarkers to precisely identify the individuals at risk of sleep disturbance and develop targeted strategies for therapeutic and clinical interventions.