Post-Mastectomy Pain Syndrome and sleep disorders: effects of physical activity

Marco Calapai¹Luisa Puzzo¹Giuseppe Bova¹Daniele Alfio Vecchio¹Rosario Blandino¹Alessia Barbagallo¹Ilaria Ammendolia²Luigi Cardia³Filippo Firenzuoli⁴Fabrizio Calapai⁵Mariaconcetta Currò⁶Giovanni Ficarra⁶Emanuela Esposito²Fabio Trimarchi⁵Debora Di Mauro⁵Gioacchino Calapai^2*Carmen Mannucci^5,7

• ¹ASP Messina, Messina, Italy
• ²Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
• ³Department of Human and Pediatric Pathology Gaetano Barresi Urologic Section, University of Messina, Messina, Italy
• ⁴School of Human Health Sciences, University of Florence, Florence, Tuscany, Italy
• ⁵Dipartimento di Scienze Biomediche, Odontoiatriche, Morfologiche e Funzionali per Immagini, Università degli Studi di Messina, Messina, Sicily, Italy
• ⁶Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
• ⁷University of Messina, Messina, Sicilia, Italy

Introduction: Aim of the study was the evaluation of physical activity effects on chronic post-surgery pain perception, sleep quality and related biomarkers (melatonin, AdrenoCorticoTropic Hormone, and cortisol) in women undergoing postmastectomy. Methods: A prospective observational unicentric cohort study was designed by recruiting women undergoing unilateral or bilateral mastectomy. One hundred and eighty (180) women were enrolled in the study according to inclusion and exclusion criteria. The mean age of the sample of patients recruited for the study was 50.34 ± 11.9 years (range 28–72 years, median age 53.5 years). The mean BMI was 21.59 ± 1.49. All the participants were Caucasian. Pain assessment, quality of sleep and motor activity of each participant in the study was measured 3 and 6 months after the intervention as well as biomarkers. Results: show that level of physical activity measured through International Physical Activity Questionnaire reduces intensity of pain and its interference with quality of life, moreover, in women with higher physical activity, results show a reduction of sleep disturbance, cortisol and ACTH levels and an increase of melatonin, compared with women with minor motor activity and lower physical activity level. Conclusions: Physical activity seems to reduce pain intensity, reduce sleep disorders together with a reduction of cortisol and ACTH and an increase of melatonin. (Clinical Trial.gov identifier: NCT06803563)