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Tolerating Uncertainty in the Dark: Insomnia Symptoms, Distress, and Well-Being Among Parents of Adolescents and Young Adults with Cancer

  • Special Issue: Sleep Science
  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

Given the need to better understand mechanisms linking poor sleep and psychological distress in the context of chronic illness, we explored a novel factor, intolerance of uncertainty (IU), in relation to insomnia among parents of adolescents and young adults (AYAs) with cancer. We hypothesized that parents with higher IU would report greater insomnia symptoms, which would be associated with higher anxiety and depressive symptoms. These greater levels of anxiety and depressive symptoms are hypothesized to mediate the relationship between insomnia symptoms and subjective well-being (SWB).

Method

Surveying 59 parents of AYAs with cancer, we computed a parallel-serial mediational analysis using bootstrapping techniques for ordinary least squares regression to test two pathways (adjusting for whether the AYA currently resided with the parent). The first serial pathway was IU→insomnia symptoms→anxiety symptoms→SWB. The second pathway was IU→insomnia symptoms→depressive symptoms→SWB.

Results

Although the first pathway involving sleep and anxiety as serial mediators was nonsignificant, the second pathway with sleep and depressive symptoms was significant. The relationship between IU and SWB was mediated through insomnia and depressive symptoms. An alternative serial mediation analysis wherein depressive symptoms preceded sleep was not significant, lending support to study findings.

Conclusion

This study provides preliminary evidence that IU’s detrimental influence on depression and SWB may operate through its influence on insomnia symptoms. Given implications for parents’ well-being and, likely, their subsequent capacity to care for the AYA with cancer, interventions addressing IU and disturbed sleep among this underserved population deserve attention.

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Notes

  1. A similar parallel-serial mediation analysis with the inclusion of the AYA child’s age as a covariate was conducted; the same pattern of results as presented in the manuscript was found.

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Funding

This study was funded by grants from the Professional Staff Congress-CUNY (TRADB-45-376) and the Hunter College Presidential Fund for Faculty Advancement to Dr. Revenson, as well as a Doctoral Student Research Grant awarded to Ms. Panjwani.

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Authors and Affiliations

  1. Doctoral Program in Psychology, The Graduate Center, City University of New York, New York, NY, USA

    Aliza A. Panjwani & Tracey A. Revenson

  2. PRIDE Health Research Consortium, Hunter College, City University of New York, New York, NY, USA

    Brett M. Millar

  3. Department of Psychology, Hunter College, City University of New York, New York, NY, USA

    Tracey A. Revenson

Authors
  1. Aliza A. Panjwani
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  2. Brett M. Millar
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  3. Tracey A. Revenson
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Correspondence to Aliza A. Panjwani.

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Panjwani, A.A., Millar, B.M. & Revenson, T.A. Tolerating Uncertainty in the Dark: Insomnia Symptoms, Distress, and Well-Being Among Parents of Adolescents and Young Adults with Cancer. Int.J. Behav. Med. 28, 14–20 (2021). https://doi.org/10.1007/s12529-020-09869-6

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  • DOI: https://doi.org/10.1007/s12529-020-09869-6

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