Cancer specific stress and insomnia severity among breast cancer patients

Abstract

Objective: Living with cancer can lead to significant stress that impacts multiple dimensions of an individual’s life (Dunn et al., 2006). Insomnia symptoms are one such adverse consequence of stress related to cancer (Palesh et al., 2006). This is particularly apparent among individuals with breast cancer, with an estimated 37% to 63% endorsing symptoms of insomnia (Davidson, MacLean, Brundage, & Schulze, 2002, Fortner, Stepanski, Wang, Kasprowicz, & Durrence, 2002; Koopman, Nouriani, Erickson, Anupindi, Butler, Bachmann, et al., 2002; Savard, Simard, Blanchet, Ivers, & Morin, 2001). Many predisposing, precipitating, and perpetuating factors are likely to contribute to insomnia among individuals with breast cancer (Savard & Morin, 2001). Additionally, mindfulness has been proposed as having an association with insomnia and related factors (Lundh, 2000). In an attempt to develop a more in depth understanding of specific predisposing, precipitating, and perpetuating factors associated with insomnia among breast cancer patients, a survey study was conducted. Methods: Fifty six breast cancer patients receiving treatment at The Cancer Institute of New Jersey at Cooper University Hospital were recruited to participate in this survey study. Results: Forty eight percent of breast cancer patients reported a clinically significant level of insomnia symptoms. A history of sleep difficulties was the only predisposing factor that accounted for a significant amount of variance in insomnia symptoms. In reference to precipitating factors, cancer specific stress contributed to the variance in insomnia symptoms above and beyond a history of sleep difficulties. Dysfunctional beliefs and attitudes about sleep did not emerge as a significant perpetuating factor. Mindfulness was not found tomoderate relationships involving insomnia symptoms among breast cancer patients.Discussion: Findings from the present study suggest that insomnia symptoms are prevalent among individuals with breast cancer. In addition, specific predisposing (history of sleep difficulties) and precipitating (cancer specific stress) factors were found to predict insomnia symptoms among our sample. Given that the relationship between cancer specific stress and insomnia symptoms among individuals with breast cancer is a novel finding, research should aim to confirm results and explore this unique relationship.%%%%Ph.D., Clinical Psychology – Drexel University, 2009