Multidimensional Sleep Health and Sleep Environment Factors in Individuals with Cancer Undergoing Outpatient Chemotherapy: An Exploratory Cross-Sectional Analysis

Purpose: Sleep problems are common amongst individuals with cancer receiving chemotherapy and are associated with poorer health outcomes. Considerable research to date has investigated specific sleep domains or symptomology, with little attention given to overall sleep health, which is more closely associated with overall health. This exploratory cross-sectional study aimed to characterize multidimensional sleep health in individuals with cancer reporting sleep complaints whilst undergoing chemotherapy, with exploratory examination of environmental associations. Patients and Methods: Twenty-three participants were included in this exploratory cross-sectional analysis. Participants were diagnosed with cancer within the last 6 months, undergoing outpatient chemotherapy at time of study entry and reported poor sleep quality and/or insomnia symptoms per the Pittsburgh Sleep Quality Index and Insomnia Severity Index. Multidimensional sleep health (duration, continuity, timing, regularity, rhythmicity, sleepiness/alertness, quality) and sleep environmental factors were assessed using sleep questionnaires, wrist-worn actigraphy and a temperature/light data logger. Linear regressions models were used to explore the association between sleep health and sleep environment factors. Results: Examination of multidimensional sleep health indicated that poor sleep quality (87%) and variable sleep timing (61%) were the most prevalent sleep complaints amongst our sample. Mean sleep health score = 3.17 (± 1.83 SD) suggests that on average, three sleep complaints were experienced by the current sample. There were no significant associations between sleep health (domain and overall) and sleep environment factors. Conclusion: Sleep quality and sleep timing were the primary concerns observed amongst our sample. Future investigations should be adequately powered and longitudinally designed to observe changes in sleep health trajectories and temporal relationships over the course of active treatment. Nevertheless, our preliminary findings provide the foundation for future research exploring sleep health amongst cancer populations and highlight that improving sleep quality and timing should be prioritized amongst individuals undergoing chemotherapy. Keywords: oncology, supportive care, sleep disturbance