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Associations among Self-Regulation, Dynamical Cardiovascular Functioning, and Sleep Health in Patients with Cancer and their Family Caregivers
Dissertation   Open access

Associations among Self-Regulation, Dynamical Cardiovascular Functioning, and Sleep Health in Patients with Cancer and their Family Caregivers

Thomas C. Tsai
Doctor of Philosophy (PhD), University of Miami
2026-06

Abstract

self-regulation dynamical cardiovascular functioning sleep cancer patient-caregiver dyad

Poor cardiovascular and sleep health are common in patients with cancer and their caregivers. Although self-regulation has been linked to these outcomes, little is known about how one’s self-regulation affects both members of the dyad. Guided by dual-process and social baseline theories, this study examined the associations of reflexive (impulsivity) and deliberative self-regulation (benefit finding) with acute cardiovascular synchrony and daily sleep health in colorectal cancer patient–caregiver dyads. We hypothesized that impulsivity would predict greater cardiovascular co-agitation and poorer sleep, whereas benefit finding would predict greater co-regulation and better sleep. We also explored whether cardiovascular synchrony moderated links between self-regulation and sleep.

Newly diagnosed colorectal cancer patients and their caregivers completed measures of impulsivity and benefit finding, participated in a dyadic laboratory stress task with continuous cardiovascular monitoring, and completed 14 days of sleep diaries and actigraphy. Results showed significant cardiovascular oscillation and coupling in patients and caregivers. Dyads exhibited cardiovascular amplification and damping depending on task phase, with coupling strongest during speech tasks and primarily driven by the speaker. Contrary to hypotheses, impulsivity and benefit finding were not associated with any cardiovascular synchrony. However, greater impulsivity predicted longer sleep onset latency, poorer sleep efficiency, and sleep rhythm differences for both oneself and one’s partner. Acute cardiovascular synchrony moderated associations involving partner sleep composition but not sleep rhythm.

These findings reveal context-dependent cardiovascular synchrony patterns in patient–caregiver dyads and highlight the role of impulsivity in shaping both individual and partner sleep health. Results underscore the dyadic nature of cancer survivorship and support interventions targeting reflexive stress-coping tendencies.

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