Insufficient sleep, depression, and self-rated health in adult cancer survivors

Abnormalities of sleep and current depression in adult cancer survivors may have adverse effects on Health-Related Quality of Life (HRQOL). The purpose of this research was to examine the effect of insufficient sleep on HRQOL indicators in adult cancer survivors and to determine if current depression mediates the effect.

Cross-sectional data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) involving adults cancer survivors were used for this study (n = 1,427). Perceived insufficient sleep (past 30 days), the primary exposure of interest, and was categorized into two groups (< 14 days vs. ≥ 14 days). The Patient Health Questionnaire 8 (PHQ-8) item scale was used to estimate the prevalence of current depression, mediator of interest, and was categorized into two groups (Present vs. Absent). HRQOL constructs measuring poor “self-rated health”, “physical health”, & “social functioning” (past 30 days) were the outcomes of interest and each was categorized into two groups (< 14 days vs. ≥ 14 days). Logistic regression models were used to examine if insufficient sleep was directly associated with HRQOL and if current depression mediates the relationship, adjusting for all potential confounders. Statistical analysis accounted for complex sampling design of the BRFSS.

Current depression significantly mediated the effect of insufficient sleep on HRQOL. The proportion of effect mediated by current depression on Physical Health was 61%, followed by Social Functioning(58.4%), and General Health(41%), after adjusting for potential confounders.

Adult cancer survivors with insufficient sleep are at risk for depressive symptoms which in turn has implications for Health-Related Quality of Life outcomes.