Sleep quality and disturbances in adolescents and young adults with cancer compared to a healthy comparison group: results of the AYA-LE study.

PURPOSE: Adolescents and young adults (AYAs) with cancer often exhibit riskier health behaviors, including poorer sleep patterns, compared to older individuals. Research on the relationship between cancer and sleep quality in AYA patients has yielded inconsistent results. This study investigates sleep quality in AYA patients compared to a healthy comparison group and examines associated sociodemographic, clinical, and psychosocial variables as well as physical activity.

METHODS

The prospective observational study included 407 AYA patients aged 18-39 years at diagnosis and 372 healthy participants aged 18-45 years, with data collected from May-September 2019. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Validated questionnaires measured self-efficacy, social support, anxiety, depression, quality of life, lack of energy, and physical activity. Multiple regression analyses were employed to explore the variables associated with sleep quality.

RESULTS

The mean age of the AYA patients was 34.8 years (75.2% women) and 32.3 years of the healthy participants (61.8% women). AYA patients demonstrated significantly poorer subjective sleep quality (d=0.31), lower sleep efficiency (d=0.15), more frequent sleep disturbances (d=0.23), greater use of sleep medication (d=0.25), and higher daytime dysfunction (d=0.29). Anxiety, depression (HADS), quality of life (EORTC), and unmet needs for support through lack of energy (SCNS) were significantly associated with PSQI (adjusted R2=0.35).

CONCLUSION

These findings underscore the relevance of sleep disturbances in AYA patients and support greater attention to sleep disturbances in survivorship care. Routine assessment of sleep quality may help identify AYA patients who could benefit from further evaluation and appropriate support.