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Sleep quality and overall survival among cancer survivors in the Netherlands: A profiles registry study
Dinnessen,Renate Beijer,Sandra Oerlemans,Simone Husson,Olga Mols,Floortje Bours,Martijn JL. Ezendam,Nicole PM.
Dinnessen,Renate
Beijer,Sandra
Oerlemans,Simone
Husson,Olga
Mols,Floortje
Bours,Martijn JL.
Ezendam,Nicole PM.
Abstract
Background This study aimed to determine whether: 1) sleep quality was associated with overall survival (OS) among a heterogeneous sample of cancer survivors; 2) this association differed per cancer diagnosis; 3) aspects of sleep quality (e.g., sleep latency, daytime dysfunction) were associated with OS among a subsample of colorectal cancer (CRC) survivors; and 4) adjustment for depressive symptoms changed these associations. Methods Several cohorts from the population-based PROFILES registry, including adult cancer survivors diagnosed between 1990 and 2014 with 11 cancer diagnoses, were used. Data on sleep quality (3 categories: no, nonclinically, and clinically important sleep quality impairment) was collected through the insomnia scale of theEORTC QLQ-C30 and the PSQI for CRC survivors only (n = 1245). Clinical data were obtained through the Netherlands Cancer Registry. Cox regression analysis was used to assess adjusted hazard ratios (HRs). Results 7195 participants were included, of which 36 % died (median follow-up since inclusion, 9 years). Clinically impaired sleep quality was associated with lower OS (HR, 1.17[1.05; 1.30]) compared to no sleep problems. Stratification by cancer diagnosis suggested a consistent pattern. After adjusting for depressive symptoms, sleep quality was no longer significantly associated with OS (HR, 1.10[0.97; 1.24]). Daytime dysfunction and long sleep duration were significantly associated with lower OS in CRC survivors, also after adjustment for depressive symptoms. Conclusion Cancer patients reporting clinically low sleep quality had a lower OS. However, this might be partly explained by patients’ depressive symptoms. In CRC survivors, daytime dysfunction and long sleep duration were, independent of depressive symptoms, related to lower OS.
Description
Date
2025-07
Journal Title
Journal ISSN
Volume Title
Publisher
Research Projects
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Journal Issue
Keywords
Cancer, Depression, Overall survival, Sleep duration, Sleep quality, SDG 3 - Good Health and Well-being
Citation
Dinnessen, R, Beijer, S, Oerlemans, S, Husson, O, Mols, F, Bours, M JL & Ezendam, N PM 2025, 'Sleep quality and overall survival among cancer survivors in the Netherlands : A profiles registry study', Sleep Medicine, vol. 131, 106488. https://doi.org/10.1016/j.sleep.2025.106488
License
info:eu-repo/semantics/openAccess