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Peer-reviewedCC BY 4.0Frontiers in Oncology

Three-year trajectories of insomnia symptoms among young breast cancer survivors

  • Chloe M. Hery1,2
  • Kayla Williams1,2
  • Sarah A. Janse3
  • Juan Peng3
  • Faiza Kalam1,2
  • Kimberly Van Zee4
  • Elizabeth Z. Naftalis5
  • Electra D. Paskett1,2
  • Michelle J. Naughton1,2
5 affiliations
  1. 1Division of Cancer Prevention & Control, College of Medicine, The Ohio State University
  2. 2The Ohio State University Comprehensive Cancer Center
  3. 3Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University
  4. 4Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center
  5. 5Health Texas Community Health Services Corporate Director of Breast Services
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Abstract

Background: Sleep disruptions are common in cancer survivors and can negatively impact quality of life. Young breast cancer survivors face unique challenges and may have distinct sleep patterns. We examined trajectories of insomnia symptoms over 3 years among young survivors.

Methods: 836 women, ≤45 years old with stage I-III breast cancer, were recruited to the Menstrual Cycle Maintenance and Quality of Life After Breast Cancer Study within 8 months of diagnosis. Insomnia symptoms were assessed at 6-month intervals from baseline through 3 years post-recruitment, using the Women’s Health Initiative Insomnia Rating Scale (WHIIRS). Group-based trajectory modeling was used to identify distinct trajectories of insomnia symptoms. The final model was chosen by comparing the average posterior probability of assignment (PPA) and examining the distinctiveness and interpretability of the trajectories. Key demographic, quality of life and clinical variables were assessed in multinomial logistic regression models as potential factors associated with group membership.

Results: The mean age of participants was 38 years (range: 20–45 years) at enrollment. Three distinct insomnia trajectories were identified: low probability of insomnia (n=277, 33.1%), moderate probability (n=354, 42.4%), and high probability (n=205, 24.5%). Average PPA was between 75%-82% for each group. Insomnia symptoms were highest at baseline but improved for the low probability and moderate probability groups. In adjusted models, older age (p=0.02), lower education (p=0.03), having received chemotherapy (p=0.03), night sweats (p=0.02), lower SF-12 physical component scores (poorer physical functioning, p<0.0001), and lower SF-12 mental health component scores (p<0.0001) were associated with participants in the moderate and high probability insomnia groups compared to those in the low probability group.

Conclusion: Insomnia symptoms are problematic for many young breast cancer survivors. Future studies are needed to determine whether early identification and intervention can modify these insomnia symptom trajectories and improve broader survivorship outcomes.

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Cite

BibTeXRIS
BibTeX
@article{hery2026threeyear,
  title = {{Three-year trajectories of insomnia symptoms among young breast cancer survivors}},
  author = {Chloe M. Hery and Kayla Williams and Sarah A. Janse and Juan Peng and Faiza Kalam and Kimberly Van Zee and Elizabeth Z. Naftalis and Electra D. Paskett and Michelle J. Naughton},
  journal = {Frontiers in Oncology},
  year = {2026},
  month = oct,
  doi = {10.3389/fonc.2026.1967396},
  url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1967396/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Three-year trajectories of insomnia symptoms among young breast cancer survivors
AU  - Chloe M. Hery
AU  - Kayla Williams
AU  - Sarah A. Janse
AU  - Juan Peng
AU  - Faiza Kalam
AU  - Kimberly Van Zee
AU  - Elizabeth Z. Naftalis
AU  - Electra D. Paskett
AU  - Michelle J. Naughton
PY  - 2026
DA  - 2026/10/19
JO  - Frontiers in Oncology
DO  - 10.3389/fonc.2026.1967396
UR  - https://www.frontiersin.org/articles/10.3389/fonc.2026.1967396/full
AB  - Background: Sleep disruptions are common in cancer survivors and can negatively impact quality of life. Young breast cancer survivors face unique challenges and may have distinct sleep patterns. We examined trajectories of insomnia symptoms over 3 years among young survivors.  Methods: 836 women, ≤45 years old with stage I-III breast cancer, were recruited to the Menstrual Cycle Maintenance and Quality of Life After Breast Cancer Study within 8 months of diagnosis. Insomnia symptoms were assessed at 6-month intervals from baseline through 3 years post-recruitment, using the Women’s Health Initiative Insomnia Rating Scale (WHIIRS). Group-based trajectory modeling was used to identify distinct trajectories of insomnia symptoms. The final model was chosen by comparing the average posterior probability of assignment (PPA) and examining the distinctiveness and interpretability of the trajectories. Key demographic, quality of life and clinical variables were assessed in multinomial logistic regression models as potential factors associated with group membership.  Results: The mean age of participants was 38 years (range: 20–45 years) at enrollment. Three distinct insomnia trajectories were identified: low probability of insomnia (n=277, 33.1%), moderate probability (n=354, 42.4%), and high probability (n=205, 24.5%). Average PPA was between 75%-82% for each group. Insomnia symptoms were highest at baseline but improved for the low probability and moderate probability groups. In adjusted models, older age (p=0.02), lower education (p=0.03), having received chemotherapy (p=0.03), night sweats (p=0.02), lower SF-12 physical component scores (poorer physical functioning, p<0.0001), and lower SF-12 mental health component scores (p<0.0001) were associated with participants in the moderate and high probability insomnia groups compared to those in the low probability group.  Conclusion: Insomnia symptoms are problematic for many young breast cancer survivors. Future studies are needed to determine whether early identification and intervention can modify these insomnia symptom trajectories and improve broader survivorship outcomes.
SN  - 2234-943X
ER  -