Elevated perceived stress scale (PSS) scores are associated with increased risk of poor sleep assessed by global PSQI scores: cancer and hypnotics-stratified analysis in an adult population-based study

Abstract

Patients with cancer tend to have an increased risk of sleep disorders. The exact association between cancer and sleep disorders remains uncertain. We aimed to investigate whether elevated perceived stress is linked to a higher risk of sleep disorders in patients with and without cancer history respectively. A total of 941 adult individuals from the Midlife in the United States (MIDUS) study were included in this study. Multivariate analyses were used for assessing the association between Perceived Stress Scale (PSS) and Global Pittsburgh Sleep Quality Index (PSQI) Score. Adjusted for age, gender, BMI, blood pressure (BP), smoking and drinking status, exercise, disease history, and blood biomarkers, elevated PSS score was significantly associated with a higher PSQI score in the linear regression model (0.189 [0.154–0.224], p 5) in the logistic regression model (1.062 [1.036–1.090], p < 0.001; Model 2). Stratified analysis showed that the association between PSS and poor sleep status was affected by hypnotics use, but not by ever cancer history. Elevated PSS is linked with a higher risk of poor sleep status in the adult population from the United States. Elevated PSS might mediate the association of cancer and poor sleep quality. Future studies need to evaluate whether reducing PSS can improve sleep status in patients with cancer history.