Abstract
Abstract Introduction Colorectal cancer is one of the most common cancers worldwide. Patients with this disease may experience gut dysbiosis and various psychoneurological symptoms (PNS) including, sleep disturbance, psychological distress, and pain. Family caregivers involved in managing their day-to-day needs may also experience similar PNS. This study aimed to explore associations between sleep characteristics and the gut microbiome in patient-caregiver dyads stratified by the presence or absence of PNS. Methods Patients with colorectal cancer and their sleep-partner caregivers (20 dyads, 55.49 years old, 60% female patients) self-reported PNS using the Patient Reported Outcomes Measurement Information System (PROMIS) once, from which participants were categorized, using K-means clustering, into normal and symptomatic PNS subgroups. Participants also completed the Sleep Consensus Diary daily for 14 consecutive days, from which sleep characteristics (sleep duration, time in bed, sleep onset latency, wake after sleep onset, and sleep efficiency) were derived. Participants provided stool samples, from which gut microbiome features were investigated using shotgun metagenomic sequencing. MetaPhAn3 for taxonomy classification and MicrobiomeAnalyst2.0 for alpha and beta diversity assessment were employed. PNS subgroup differences in differential taxa abundance, alpha and beta diversity, and gut microbiome feature associations with sleep characteristics were tested separately for patients and caregivers. Results 55% of patients and 35% of caregivers were categorized into the symptomatic subgroup. Although no significant differences were observed in alpha and beta diversity between PNS subgroups, nine taxa were uniquely abundant in patients and five in caregivers (unadjusted p<.05) that differed between the PNS subgroups. Regarding sleep characteristics, among patients, greater sleep efficiency (p=.015), shorter time in bed (p=.043), and longer wake after sleep onset (p=.024) were associated with greater alpha diversity (assessed by the Simpson’s Diversity Index). However, no significant associations of sleep with alpha and beta diversity were found in caregivers. Conclusion Findings suggest sleep disturbance may be a psychoneurological contributor to gut dysbiosis in patients with colorectal cancer. Future investigations to elucidate bidirectional associations between sleep and gut health, one’s psychobehavioral impact on the partner’s gut microbiome, and other psychoneurological markers that are attributable to caregivers’ gut dysbiosis, with a larger sample and prospective longitudinal design, are warranted. Support (if any)