Sleep and Activity Patterns in Pre-menopausal Breast Cancer Patients on Tamoxifen Using a Wrist-worn Internet of Things Device
Sleep and Activity Patterns in Pre-menopausal Breast Cancer Patients on Tamoxifen Using a Wrist-worn Internet of Things Device
The aim of this study is to observe the sleep and activity patterns of pre-menopausal breast
 cancer patients taking tamoxifen using a wrist-worn internet of things device and
 questionnaires.
Breast cancer is the most common malignant tumors occurring in women worldwide. Treatments
 include surgery, radiation therapy, chemotherapy, hormone therapy, and target therapy. As
 multidisciplinary treatment improves breast cancer survival, there is a growing interest in
 the quality of life of breast cancer survivors. Common symptoms that patients with breast
 cancer continue to complain of during or after their treatment include fatigue, pain,
 depression, sleep disorders, weight gain and hot flashes.

 There are only a few studies investigating sleep problems in breast cancer patients, which
 mostly relied on surveys. A commonly used survey evaluation method is the Pittsburg Sleep
 Quality Index (PSQI). Using PSQI, one study reported that 66% of the Chinese breast cancer
 survivors had sleep disorders and 49% had significantly reduced sleep efficiency and time in
 bed. The group with sleep disorder had lower quality of life, more depression and higher
 overall stress than the group without sleep disorder. Another survey of breast cancer
 patients over 69 years old found that pain, fatigue and depression were related to sleep, and
 that fatigue was the strongest predictor of sleep disorders.

 A recent study found that postmenopausal breast cancer patients, starting hormone therapy
 with aromatase inhibitor, total sleep time and sleep efficiency declined without statistical
 significance. However, 58% of Korean breast cancer patients are pre-menopausal patients aged
 49 or younger, and thus, most patients take tamoxifen and goserelin instead of aromatase
 inhibitors after surgery. In this reason, results of aromatase inhibitor can not be applied
 in this population. As previous studies on the effects of tamoxifen on sleep were conducted
 retrospectively, objective comparisons of before and after applying tamoxifen are difficult
 and the long-term effects of tamoxifen are difficult to understand.

 The aim of this study is to observe the sleep and activity patterns of pre-menopausal breast
 cancer patients taking tamoxifen using a wrist-worn internet of things device and
 questionnaires.
Inclusion Criteria:

 -  diagnosed of unilateral breast cancer (stage 0 ~III)

 -  underwent proper cancer treatment including surgery, chemotherapy, radiation therapy

 -  age : 18 ~ 45

 -  scheduled for applying tamoxifen and goserelin

 Exclusion Criteria:

 -  need CPAP device during sleep due to sleep apnea

 -  under medication for restless leg syndrome

 -  previous history of tamoxifen

 -  irregular bedtime due to shift work

 -  diagnosed of recurrent or metastatic cancer

 -  have difficulty understanding and conducting surveys and verbal instructions due to
 severe cognitive, communication and perception problems

 -  refuse to participate

 -  has musculoskeletal system and neurological damage and lesions