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Peer-reviewedCC BY 4.0Journal of Cancer Survivorship

Relationship between sleep-related impairment and cognitive functioning among breast cancer survivors

  • Victoria M. Telles1,2
  • Victoria Mac1
  • Rowena Tam1,2,3
  • Marisa Torres-Ruiz2
  • Sheri J. Hartman1,4
4 affiliations
  1. 1Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA USA
  2. 2San Diego State University, San Diego, CA USA
  3. 3Doctor of Physical Therapy Program, San Diego State University, San Diego, CA USA
  4. 4Moores Cancer Center, University of California, San Diego, La Jolla, CA USA
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Abstract

Purpose: Sleep-related impairment and cancer-related cognitive decline (CRCD) are common, disruptive symptoms affecting breast cancer survivors. This study examined the association between sleep-related impairment and both self-reported and objective cognitive functioning in breast cancer survivors following treatment.

Methods: Participants (N = 253) from the I Can! Improving Cognition After Cancer study completed the NIH Toolbox Digit Symbol test to measure Processing Speed and a battery of neurocognitive tests of Memory, Executive Functioning, and Attention domains. Self-reported cognition was assessed with the PROMIS Cognitive Function and Abilities scales. Sleep-related impairment was measured by the PROMIS Sleep-Related Impairment scale. Multiple linear regression models were used to examine the associations between sleep-related impairment and the six cognitive outcomes, adjusting for demographic and cancer treatment factors.

Results: Participants were on average 59 (SD = 8.9) years old, majority identified as White (77%) and were college graduates (42%). Fifty-seven percent of participants underwent chemotherapy, 80% received hormone therapy, and 81% were treated with radiation. Greater sleep-related impairment was significantly associated with worse executive function (β = −0.01, 95% CI: −0.022, −0.000, p = 0.04), worse cognitive abilities (β = −0.28, 95% CI: −0.375, −0.184, p < 0.001), and worse cognitive function (β = −0.25, 95% CI: −0.323, −0.167, p < 0.001). No significant associations were observed for memory, attention, or processing Speed.

Conclusion: Greater sleep-related impairment was associated with poorer self-reported cognitive functioning and modest differences in executive functioning among breast cancer survivors, underscoring the importance of addressing sleep-related impairment in this population.

Implications for Cancer Survivors: Assessing sleep-related impairment during survivorship care may help identify survivors experiencing cognitive difficulties and related daytime functional concerns.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02057-7.

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Cite

BibTeXRIS
BibTeX
@article{telles2026relationship,
  title = {{Relationship between sleep-related impairment and cognitive functioning among breast cancer survivors}},
  author = {Victoria M. Telles and Victoria Mac and Rowena Tam and Marisa Torres-Ruiz and Sheri J. Hartman},
  journal = {Journal of Cancer Survivorship},
  year = {2026},
  month = jun,
  doi = {10.1007/s11764-026-02057-7},
  url = {https://doi.org/10.1007/s11764-026-02057-7},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Relationship between sleep-related impairment and cognitive functioning among breast cancer survivors
AU  - Victoria M. Telles
AU  - Victoria Mac
AU  - Rowena Tam
AU  - Marisa Torres-Ruiz
AU  - Sheri J. Hartman
PY  - 2026
DA  - 2026/06/13
JO  - Journal of Cancer Survivorship
DO  - 10.1007/s11764-026-02057-7
UR  - https://doi.org/10.1007/s11764-026-02057-7
AB  - Purpose: Sleep-related impairment and cancer-related cognitive decline (CRCD) are common, disruptive symptoms affecting breast cancer survivors. This study examined the association between sleep-related impairment and both self-reported and objective cognitive functioning in breast cancer survivors following treatment.  Methods: Participants (N = 253) from the I Can! Improving Cognition After Cancer study completed the NIH Toolbox Digit Symbol test to measure Processing Speed and a battery of neurocognitive tests of Memory, Executive Functioning, and Attention domains. Self-reported cognition was assessed with the PROMIS Cognitive Function and Abilities scales. Sleep-related impairment was measured by the PROMIS Sleep-Related Impairment scale. Multiple linear regression models were used to examine the associations between sleep-related impairment and the six cognitive outcomes, adjusting for demographic and cancer treatment factors.  Results: Participants were on average 59 (SD = 8.9) years old, majority identified as White (77%) and were college graduates (42%). Fifty-seven percent of participants underwent chemotherapy, 80% received hormone therapy, and 81% were treated with radiation. Greater sleep-related impairment was significantly associated with worse executive function (β = −0.01, 95% CI: −0.022, −0.000, p = 0.04), worse cognitive abilities (β = −0.28, 95% CI: −0.375, −0.184, p < 0.001), and worse cognitive function (β = −0.25, 95% CI: −0.323, −0.167, p < 0.001). No significant associations were observed for memory, attention, or processing Speed.  Conclusion: Greater sleep-related impairment was associated with poorer self-reported cognitive functioning and modest differences in executive functioning among breast cancer survivors, underscoring the importance of addressing sleep-related impairment in this population.  Implications for Cancer Survivors: Assessing sleep-related impairment during survivorship care may help identify survivors experiencing cognitive difficulties and related daytime functional concerns.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02057-7.
SN  - 1932-2259
SN  - 1932-2267
ER  -