An Assessment of Sleep Duration and Determinants of Health in a Cross-Sectional Sample of Gynecologic Cancer Survivors in Los Angeles County

Abstract

Cancer survivors have an increased risk of treatment-related deficits in physical health and low health-related quality of life. In this cross-sectional study, a health questionnaire was mailed to women from the Los Angeles County Cancer Surveillance Program aged 45-70 and diagnosed with cervical, endometrial, or ovarian cancer in 2005-2014. Of the 5,941 surveys with valid postal addresses, 586 (10%) were completed and returned. The average age of respondents was 66 years old, and 36% identified as non-white. Non-white respondents were less likely to have a college degree (p<0.001), more likely to sleep for less than seven hours each night (p<0.001), experience bodily pain (p<0.001), and have a diagnosis of cervical cancer (p=0.002), when compared to white respondents. Health behaviors and determinants were examined across cervical, endometrial, and ovarian cancer cases. Cervical cancer survivors reported sleeping less than 7 hours per night, on average (p=0.015). Race was associated with sleep duration among endometrial (p=0.002) and ovarian (p=0.003) cancer survivors. Menopausal status was associated with the relationship between race and sleep duration (p<0.001). Depression was inversely related to sleep duration (p = 0.022) but was not associated with race, menopausal status, time since treatment, physical activity, or cancer type. Postmenopausal cervical cancer survivors reported a moderate concern about fall risk compared to their premenopausal counterparts (p=0.048). Physical activity levels increased as time since treatment increased (p=0.003) regardless of cancer type. Race, menopausal status, depression, and cancer type impacted the sleep duration. KEYWORDS: Health Disparities; Sleep Duration; Depression; Gynecologic Cancers; Survivorship Care