Poor sleep quality persists over time for breast cancer patients

Woman lying in bed with hands over face and alarm clock in the foreground.

Published February 28, 2024

Multiple sleep factors worsen during the year following diagnosis and after treatment.


Nouf Alanazi, PhD candidate in the School of Nursing, was recently published in Oncology Nursing Forum for her research examining sleep quality and self-reported causes of sleep disturbances among breast cancer patients. The researchers surveyed nearly 500 participants at the time of diagnosis and again one year later.

Sleep quality, Alanazi says, is critically important for overall health and wellbeing. Studies have shown that poor sleep is associated with cancer, increased risk of mortality, diabetes, and obesity, among other health issues. And, with breast cancer being the most common form of cancer in women worldwide, the researchers call sleep quality issues in these patients and survivors “alarming.”

Alanazi’s research team examined participants’ Pittsburgh Sleep Quality Index scores, a questionnaire that scores sleep quality factors, such as how long it takes to fall asleep. They found that the study participants’ sleep scores decreased, meaning their sleep quality worsened over time. This could suggest that cancer diagnoses and treatments may make it more difficult for people to sleep well – something the researchers say should be explored further.

The study also identifies common reasons breast cancer patients have trouble sleeping: waking up in the middle of the night, not being able to fall asleep within 30 minutes, needing to go to the bathroom and feeling too hot. Participants also said worrying, feeling pain, or being disturbed by their bed partner or spouse made it hard to sleep.

Alanzai says it’s crucial for oncology practitioners to recognize that breast cancer patients and survivors experience worry and anxiety, “which may promote additional deterioration in sleep quality.” Her research team says it’s important for oncology nurses to screen for psychological distress and other symptoms related to sleep. Understanding these factors can help health care providers find ways to help breast cancer patients and survivors sleep better.

Additional authors include Fangyi Gu, MD, ScD, Roswell Park Comprehensive Cancer Center; Chin-Shang Li, MS, PhD, University of Rochester Medical Center; Rebecca Lorenz, University of Buffalo/The Ohio State University; and Chi-Chen Hong, PhD, Roswell Park Comprehensive Cancer Center.