Determinants of sleep duration among gynecologic cancer survivors

Background: Sleep disturbances impact quality of life among gynecologic cancer survivors (GCS), yet comprehensive understanding of sleep determinants remains limited.Methods: We analyzed National Health Interview Survey (2009–2018) data among GCS (N = 1,680). Sleep duration was categorized as short (< 7 h), optimal (7–9 h), or long (< 9 h). Multinomial logistic regression models examined associations with lifestyle factors, health outcomes, and social determinants of health adjusting for age, BMI, and year with optimal sleep being the reference.Results: Among GCS, 37.9% reported short sleep, 57.1% optimal sleep, and 5.0% long sleep. In the fully adjusted model, women reporting fair/poor health compared to excellent/very good/good health had higher odds of short sleep (aOR = 1.93, 95% CI: 1.38–2.71) and long sleep (aOR = 4.12, 95% CI: 2.10–8.09). Women with graduate degrees, compared to those with less than high school education (aOR = 1.87, 95% CI: 1.23–2.83) and high school graduation (aOR = 1.52, 95% CI: 1.10–2.10) had higher odds of short sleep. Uninsured women compared to insured women had lower odds of short sleep (aOR = 0.54, 95% CI: 0.34–0.84) and long sleep (aOR = 0.39, 95% CI: 0.19–0.78).Conclusions: These findings highlight the importance of addressing social determinants and health equity in sleep interventions for cancer survivors.