ArticleJournal of the National Cancer Institute2022
New and Persistent Sedative-Hypnotic Use After Adjuvant Chemotherapy for Breast Cancer.
Article in Journal of the National Cancer Institute, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- The Effectiveness of Acupressure on Sleep Quality in Cancer Patients: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.Journal of clinical nursing · 2025Pooled it
- Bilateral transcutaneous auricular vagus nerve stimulation for the treatment of insomnia in breast cancer.Scientific reports · 2025Trial
- Pharmacologic management of postoperative sleep disturbance in breast cancer.Frontiers in pharmacology · 2026Review
- Perioperative Benzodiazepine Exposure Impacts Risk of New Persistent Benzodiazepine Use Among Patients with Cancer.Annals of surgical oncology · 2025Article
- Factors associated with the sleep disturbances of people with breast cancer during chemotherapy in China: A cross-sectional study.Nursing open · 2023Article
- Unintended Negative Consequences of Managing Chemotherapy Toxicity.Journal of the National Cancer Institute · 2022Article
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundSedative-hypnotic medications are used to treat chemotherapy-related nausea, anxiety, and insomnia. However, prolonged sedative-hypnotic use can lead to dependence, misuse, and increased health-care use. We aimed to estimate the rates at which patients who receive adjuvant chemotherapy for breast cancer become new persistent users of sedative-hypnotic medications, specifically benzodiazepines and nonbenzodiazepine sedative-hypnotics (Z-drugs).
methodsUsing the MarketScan health-care claims database, we identified sedative-hypnotic-naïve patients who received adjuvant chemotherapy for breast cancer. Patients who filled 1 and more prescriptions during chemotherapy and 2 and more prescriptions up to 1 year after chemotherapy were classified as new persistent users. Univariate and multivariable logistic regression analyses were used to estimate odds of new persistent use and associated characteristics.
resultsWe identified 22 039 benzodiazepine-naïve patients and 23 816 Z-drug-naïve patients who received adjuvant chemotherapy from 2008 to 2017. Among benzodiazepine-naïve patients, 6159 (27.9%) filled 1 and more benzodiazepine prescriptions during chemotherapy, and 963 of those (15.6%) went on to become new persistent users. Among Z-drug-naïve patients, 1769 (7.4%) filled 1 and more prescriptions during chemotherapy, and 483 (27.3%) became new persistent users. In both groups, shorter durations of chemotherapy and receipt of opioid prescriptions were associated with new persistent use. Medicaid insurance was associated with new persistent benzodiazepine use (odds ratio = 1.88, 95% confidence interval = 1.43 to 2.47) compared with commercial or Medicare insurance.
conclusionsPatients who receive sedative-hypnotic medications during adjuvant chemotherapy for breast cancer are at risk of becoming new persistent users of these medications after chemotherapy. Providers should ensure appropriate sedative-hypnotic use through tapering dosages and encouraging nonpharmacologic strategies when appropriate.
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