Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients With Cancer and Their Caregivers

Abstract

Objective Cancer can be a traumatic experience affecting multidimensional aspects of sleep among patients and caregivers. This study examined the differential associations of cancer-related post-traumatic stress symptoms (PTSS) with various sleep markers in this population. Methods Patients newly diagnosed with colorectal cancer (n = 138, mean age = 56.93 years, 31.88% female, 60.14% Hispanic, 6.53 months post-diagnosis) and their sleep-partner caregivers (n = 138, mean age = 55.32 years, 68.12% female, 57.97% Hispanic) completed questionnaires assessing the four PTSS clusters (intrusion, avoidance, alterations in arousal and reactivity, negative alterations in cognitions and mood). Participants also completed daily sleep diaries for 14 consecutive days, from which sleep onset latency (SOL), wake after sleep onset (WASO), and sleep duration were derived. Results Actor-partner interdependence model revealed that caregivers’ greater alterations in arousal and reactivity were associated with their own longer SOL (b = 14.54, p < .001) and their patients’ longer sleep duration (b = 0.47, p = .040), whereas patients’ arousal and reactivity were associated with their caregivers’ shorter SOL (b = -8.34, p = .047) and WASO (b = -8.12, p = .019). Patients’ and caregivers’ greater negative alterations in cognitions and mood were associated with patients’ longer SOL (b = 8.89, p = .016) and shorter sleep duration (b = -0.40, p = .038), respectively. Caregivers’ greater intrusion was related to their own shorter SOL (b = -10.92, p = .002). Conclusions The four PTSS clusters, particularly arousal and reactivity and negative cognitions and mood, have distinct associations with sleep markers individually and dyadically in patients and caregivers affected by cancer. Investigations of psychosocial and biobehavioral pathways underlying these relations are warranted. Tailored trauma treatments and sleep interventions may improve the well-being of this population.

Exploring the Interplay Between Stress, Sleep, and Health: A Special Issue Commemorating the Contributions of Dr. Martica Hall

“…These articles cover a wide range of topics, methodologies, and populations that collectively demonstrate the widespread impact of stress and sleep on health. We believe Tica would have been pleased to see a single issue addressing topics as diverse as the impact of sleep on cardiovascular health in physicians experiencing burnout (1); the role of biobehavioral rhythm stability in predicting the metabolic syndrome (2); dyadic sleep influences on posttraumatic symptoms among cancer patients and their caregivers (3); and prospective, often bidirectional associations between sleep and psychosocial factors (4–6) and mental health (7,8). Several articles also highlight the dynamic nature of sleep during critical periods across the life span (9) and multidimensional conceptualizations of sleep health (10), ideas and methodologies championed by Tica.…”