Body image dissatisfaction and lower self-esteem as major predictors of poor sleep quality in gynecological cancer patients after surgery: cross-sectional study.

BACKGROUND: Sleep quality is among the indicators associated with the quality of life of patients with cancer. A multitude of factors may affect patient sleep quality and are considered as associated predictive factors. The aim of this study was to examine the predictors of poor sleep quality in Moroccan women with gynecological cancer after radical surgery. METHODS: A cross-sectional study was carried out at the Oncology Department of the Ibn Rochd University Hospital, Casablanca (Morocco), on women who had undergone radical surgery for gynecological cancer (n = 100; mean age: 50.94 years). To assess sleep quality, symptoms of depression and anxiety, self-esteem and body image, the following translated and validated Arabic versions of the tools were used: Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, Rosenberg's Self-Esteem Scale and Body Image Scale. To determine predictors of sleep quality, multiple linear and hierarchical regressions were used. RESULTS: 78% of participants were considered poor sleepers, most of them exhibited very poor subjective quality (53%), longer sleep onset latency (55%), short period of sleep (42%) and low rate of usual sleep efficiency (47%). 79% of these patients did not use sleep medication and 28% were in poor shape during the day. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. Higher PSQI scores were positively correlated with higher scores of anxiety, depression, body image dissatisfaction and with lower self-esteem (p < 0.001). The medical coverage system, body image dissatisfaction and low self-esteem predicted poor sleep quality. After controlling for the socio-demographic variables (age and medical coverage system), higher body image dissatisfaction and lower self-esteem significantly predicted lower sleep quality. CONCLUSION: Body image dissatisfaction and lower self-esteem were positively linked to sleep disturbance in women with gynecological cancer after undergone radical surgery. These two predictors require systematic evaluation and adequate management to prevent sleep disorders and mental distress as well as improving the quality of life of these patients.

Relationship between Sleep Quality and Anxiety-Depressive Disorders in Moroccan Women with Breast Cancer: A Cross-Sectional Study.

Background: Breast cancer is the most common female cancer in the world. Sleep disruption is one of the major problems of breast cancer patients. This study aimed to evaluate the quality of sleep in a group of Moroccan women with breast cancer and analyze the association between sleep quality, depression, and anxiety. Methods: This cross-sectional study was carried out among 337 Moroccan women treated for breast cancer at the Mohammed VI Cancer Treatment Center in Casablanca in 2019. A questionnaire was designed for this purpose based on two scales: Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety Depression Scale (HADS). Results: 71.5% of the participants had significant sleep disturbances; the subjective quality of patients' sleep was considered to be quite poor (20.8%) and 43.9% of participants need more than 60 minutes to fall asleep. The average sleep duration was 6.16 h/night and 84.3% of patients had not taken sleep medicines in the last month. The most common reasons for sleep disturbances were getting up to use the bathroom (67.4%) and waking up in the middle of the night or early morning (54%). Anxiety and depression were positively correlated with PSQI scores. Conclusion: The present study highlights how much breast cancer patients are vulnerable to psychological disorders and then incites the decision makers in oncology departments to implement rigorous psychological health care strategies in order to ameliorate mental health and sleep quality of breast cancer patients.

Endothelium-dependent vascular relaxation induced by Globularia alypum extract is mediated by EDHF in perfused rat mesenteric arterial bed.

The vasodilatory effect of Globularia alypum L. (GA) extract was evaluated in rat mesenteric arterial bed pre-contracted by continuous infusion of phenylephrine (2-4 ng/mL). Bolus injections of GA elicited dose-response vasodilation, which was abolished after endothelium removal. Addition of a nitric oxide synthase inhibitor, N(G)-nitro-l-arginine methyl ester (100 µmol/L), alone or in the presence of a cyclooxygenase inhibitor, indomethacin (10 µmol/L), did not significantly affect the vasodilation of the mesenteric arterial bed in response to GA extract. These results suggest that GA-induced vasodilation is endothelium dependent but nitric oxide and prostacyclin independent. In the presence of high K(+) (60 mmol/L), the GA vasodilatory effect was completely abolished, suggesting that the vasodilation effect is mediated by hyperpolarization of the vascular cells. Also, pre-treatment with atropine (a muscarinic receptors antagonist) antagonized the GA-induced vasodilation, suggesting that the vasodilatory effect is mainly mediated by the endothelium-derived hyperpolarizing factor through activation of endothelial muscarinic receptors.