Abstract
Abstract Introduction Cancer survivors experience an increased stress burden. Twenty-five percent (25%) of cancer survivors experience persistent depressive and anxiety symptoms and 40% are afflicted with chronic sleep problems. Analysis of this relationship between survivors’ mental health and sleep may elucidate components of stress burden in a particularly vulnerable population. This study examined the relationship between anxious and depressive symptoms and frequency predicting sleep patterns, comparing individuals with a cancer history versus those without. Methods Data emanated from the 2020 National Health Interview Survey dataset (n=31,568). Six percent (n=1936) of respondents reported a cancer history. The primary outcome was sleep duration, based on the average hours of sleep per night an individual reported over the past month, which was coded into “healthy” (7-8 hrs.) vs “unhealthy” (< 7 hrs. or > 9 hrs.) sleep. Level of anxiety and depression as well as frequency of reported symptoms were included in the models as predictors. Binary logistic regression models were performed to determine the discrete impact of depression and anxiety on sleep duration among individuals with and without a cancer history. Adjusted models included the demographic covariates of age, sex, education, household income, and race. Results In adjusted models, frequency of anxious feelings (OR = 1.19, p<.01,), frequency of depressive feelings (OR =1.29, p<.01,), level of anxious feelings (OR = 1.38, p<.01,), and level of depressive feelings (OR=1.15, p<.01) significantly predicted unhealthy sleep in the full sample. However, among individuals with a cancer history, frequency of anxious feelings (OR =1.16, p<.01,), level of anxious feelings (OR = 1.28, p<.01,) and frequency of depressive feelings (OR = 1.23, p<.01,) significantly predicted unhealthy sleep duration, but level of depressive feelings did not (OR = 1.08, p=.13,). Conclusion Mental health and sleep are closely and bidirectionally connected in the general population, but among individuals with a history of cancer the link between level of depression and healthy sleep were not significant. Further research is needed to understand the complex relationship between mental health and sleep among people with a cancer history. Support (if any) K01HL135452, K07AG052685, R01AG072644, R01HL152453, R01MD007716, R01HL142066, R01AG067523, R01AG056031, and R01AG075007.
