Relationship between sleep problems and psychological outcomes in adolescent and young adult cancer survivors and controls
Open accessAbstract
Purpose How cancer history and distress relate to sleep outcomes of adolescents and young adults (AYAs) is unclear. The current study compares AYA cancer survivors to controls on indicators of sleep and fatigue; examines the concurrent association between psychological status, sleep, and fatigue; and investigates the lagged relationship between sleep and fatigue problems with psychological functioning.Methods AYA cancer survivors (n = 167) and controls (n = 170), ages 16 to 30, completed measures at a survivorship clinic/primary care visit (time 1) and 2 months later (time 2). Participants completed questions about sleep quality, quantity, sleep medication use, self-reports of sleep problems, and fatigue in addition to measures of depression, anxiety, and posttraumatic stress symptoms (PTSS).Results There were no differences in sleep quantity or quality between survivors and controls, but survivors reported significantly more fatigue. Within groups, AYAs with self-reported sleep and fatigue problems reported significantly higher depression, anxiety, and PTS symptoms. Controlling for baseline depression, sleep, and fatigue problems at time 1 significantly predicted depression at time 2 in survivors but not in controls.Conclusion This study offers important insight into the psychological functioning of childhood cancer survivors and prospectively describes sleep and fatigue as risk factors for poor psychological functioning in survivors. These findings support screening for sleep problems in AYA survivors as these difficulties are closely related to mental health functioning.
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Physical symptoms and emotional distress contribute to significant social, economic, and health burdens for young adult cancer survivors.
“Consequently, physical symptoms and emotional distress contribute to significant social, economic, and health burdens for YA at a time when they should otherwise be on an upward social, economic, and health trajectory [18–22].”
From Improving symptom management for survivors of young adult cancer: rationale and study protocol for a pilot randomized controlled trial (2024) · cites this paper as [21]
The Results report that survivors with sleep or fatigue problems had more health concerns and psychological symptoms. The Discussion says these problems may impair school and social functioning, but the paper does not establish an economic burden or the claimed upward social, economic, and health trajectory. It also treats the effect on social functioning as a possibility, not a demonstrated consequence. (LLM, conf=0.85)
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- Authors
- Daniel, L., Kazak, A. E., Li, Y., Hobbie, W., Ginsberg, J., Butler, E., & Schwartz, L.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Thomas Jefferson University (US)
- Corresponding author
- Daniel, Lauren
- Venue
- Supportive Care in Cancer
- Published
- 2015-07-01
- Volume
- 24
- Issue
- 2
- Pages
- 539-546
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- PMC
- PMC4690768
- OpenAlex
- W776513409
- Cited by
- 77
- References
- 47
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 9 · 2023: 3 · 2022: 9 · 2021: 8 · 2020: 11 · 2019: 10 · 2018: 10 · 2017: 3 · 2016: 5 · 2015: 1 · 2013: 1
- FWCI
- 6.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (L40 HL115784)
- National Cancer Institute (CA106928, R01CA106928, P30CA016520)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- adolescent and young adult cancer survivors, sleep disorders, fatigue, depression, anxiety, posttraumatic stress symptoms, psychological functioning, childhood cancer survivors, sleep quality, sleep medication use, mental health screening
- MeSH terms
- Adolescent, Adult, Anxiety, Mental Disorders, Depression, Fatigue, Female, Humans, Male, Mental Health, Neoplasms, Quality of Life, Risk Factors, Sleep, Sleep Wake Disorders, Survivors, Young Adult
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