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Determinants of sleep quality in 5835 individuals living with and beyond breast, prostate, and colorectal cancer: a cross-sectional survey

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Abstract

Purpose

The present study aimed to quantify the level of sleep problems in 5835 breast, prostate, and colorectal cancer survivors, and explore a number of potential determinants of poor sleep quality in the present sample. BMI, diet, and physical activity were of particular interest as potential determinants.

Methods

Participants who completed the ‘Health and Lifestyle after Cancer’ survey were adults who had been diagnosed with breast, prostate, or colorectal cancer (mean time since cancer diagnosis was 35.5 months, SD=13.56). Sleep quality was assessed using the Pittsburgh Sleep Quality Index. BMI was calculated from self-reported height and weight. Participants were categorised as meeting/not meeting the World Cancer Research Fund (WCRF) recommendations for fibre, fruit and vegetables, added sugar, red meat, processed meat, fat, alcohol, and physical activity. Analyses accounted for demographic and clinical factors.

Results

Fifty-seven percent of those with sleep data were classified as poor sleepers (response rate 79%). Being female, having a higher number of cancer treatments, more comorbid conditions, and being more anxious/depressed increased the odds of being a poor sleeper. After adjustment for these factors, there were no associations between diet/alcohol/physical activity and sleep. However, BMI was associated with sleep. Individuals in the overweight and obese categories had 22% and 79% higher odds of being poor sleepers than individuals in the underweight/healthy weight category, respectively.

Conclusions

The findings suggest that there may be a need to develop sleep quality interventions for cancer survivors with obesity. Even after adjustment for multiple clinical and demographic factors, BMI (particularly obesity) was associated with poor sleep. Thus, researchers and health professionals should find ways to support individuals with overweight and obesity to improve their sleep quality.

Implications for Cancer Survivors

The present findings highlight that poor sleep is a common issue in cancer survivors. Interventions seeking to improve outcomes for cancer survivors over the longer term should consider sleep quality.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Notes

  1. Items 5d and 5j and 10a–e of the PSQI were omitted for the present survey and scoring was adjusted accordingly.

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Acknowledgements

The authors would like to thank Cancer Research UK for funding the Advancing Survivorship Cancer Outcomes Trial (ASCOT) [22], from which the survey data used in the present study was obtained. The authors also wish to thank the NHS trusts who helped recruit participants and the participants for taking the time to complete the measures.

Funding

ASCOT was funded by Cancer Research UK (grant numbers C43975/A27498, C1418/A14133).

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Authors and Affiliations

  1. Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK

    Silje Aronsen, Rana Conway, Phillippa Lally, Anna Roberts, Helen Croker, Rebecca J. Beeken & Abigail Fisher

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  1. Silje Aronsen
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Contributions

SA, RC, PL, AR, HC, RB, and AF designed the study; RC, AR, and HC collected the data; SA, RC, and AF analysed the data; SA, RC, PL, RB, and AF interpreted the data. SA drafted the manuscript, and RC, AF, PL, RB, AR, and HC revised it critically for intellectual content and finally approved the version to be submitted.

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Correspondence to Silje Aronsen.

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Ethical approval was obtained through the National Research Ethics Service Committee South Central—Oxford B (reference number 14/SC/1369).

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The following statement was provided on the questionnaire: ‘By completing this questionnaire you are consenting to your anonymous information being used for research on lifestyle in people diagnosed with cancer’.

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The authors declare no competing interests.

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Rebecca J Beeken and Abigail Fisher are joint senior authors.

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Aronsen, S., Conway, R., Lally, P. et al. Determinants of sleep quality in 5835 individuals living with and beyond breast, prostate, and colorectal cancer: a cross-sectional survey. J Cancer Surviv 16, 1489–1501 (2022). https://doi.org/10.1007/s11764-021-01127-2

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