Background
The factors associated with sleep disorder are controversial. This study aimed to evaluate the prevalence of sleep disorder and the factors associated with sleep disorder among Korean adult cancer survivors.
Methods
In this cross-sectional study, we collected data on sleep problems as outcome variables, and sociodemographic and clinical information as predictor variables from cancer survivors at two university-affiliated hospitals. Sleep disorder was defined as “a difficulty in sleep initiation or sleep maintenance at least 3 times a week that started after a cancer diagnosis.” Multiple logistic regression analysis was performed with odds ratios (OR) and 95% confidence intervals (95% CI) to evaluate the factors associated with sleep disorder.
Results
The participants were 1,893 Korean cancer survivors (mean age, 58.1 years; females 68.0%). The prevalence of sleep disorder among male and female cancer survivors were 16.5% and 20.3%, respectively. An increase of age by 1-year was associated with a 1.04 (95% CI, 1.01–1.07; P=0.011) times higher risk of sleep disorder in males, while an inverse association was found in females. In female survivors, high fear of cancer recurrence (FCR), high anxiety, menopause, and high EuroQol Visual Analog Scale were associated with 1.45 (95% CI, 1.06–1.98; P=0.020), 1.78 (95% CI, 1.25–2.55; P=0.002), 1.70 (95% CI, 1.08–2.67; P=0.022), and 0.59 (95% CI, 0.43–0.82; P=0.002) times higher risk of sleep disorder, respectively. In male survivors, living with a spouse/or partner was associated with 57% (95% CI, 0.20–0.95; P=0.036) lower risk of sleep disorder. Analyses of cancer sites showed that the factors associated with sleep disorder varied across cancer sites.
Conclusion
One-fifth of adult cancer survivors had sleep disorder. Age, menopausal status, FCR, anxiety, living with a spouse or partner, and quality of life were independently associated with sleep disorder in Korean cancer survivors.

Citations

• Social support, fear of cancer recurrence and sleep quality in breast cancer: A moderated network analysis
  Yingting Jiang, Xinyu Wu, Hongman Li, Ying Xiong, M. Tish Knobf, Zengjie Ye
  European Journal of Oncology Nursing.2025; 74: 102799.     CrossRef
• Subgroups of sleep quality and associated risk factors in patients with cancer undergoing radiotherapy: A cross-sectional study based on latent profile analysis
  Liuna Bi, Xian Zhang, Linlin Wang, Yanxiu Cai, Jing Han
  European Journal of Oncology Nursing.2024; 68: 102488.     CrossRef

Background
This study aimed to evaluate the association between complementary and alternative medicine (CAM) use and fear of cancer recurrence (FCR) among breast cancer survivors, using a validated multidimensional FCR-assessing instrument. Despite the debate over its medical effects, the use of CAM in breast cancer survivors is increasing.
Methods
We recruited 326 breast cancer survivors who had completed the primary cancer treatment. Information on CAM use was obtained using a self-administered questionnaire, and FCR was assessed using the Korean version of the FCR Inventory (FCRI). Multivariate linear regression analysis was performed to evaluate the association between CAM use and FCR.
Results
CAM users had higher total FCR scores than CAM non-users after covariate adjustment (CAM users: 74.6 vs. CAM non-users: 68.7; P=0.047). Among the FCRI subscales, CAM users showed higher coping strategy scores (CAM users: 22.3 vs. CAM non-users: 20.6; P=0.034) in the multivariable adjusted analysis. The use of multiple types of CAM was associated with increased FCR in a dose-dependent manner (P=0.002).
Conclusion
Breast cancer survivors who used CAM had a higher FCR than CAM non-users. The dose-response relationship between the use of multiple types of CAM and FCR suggests that breast cancer survivors who use multiple types of CAM should be provided with appropriate psychological interventions to decrease FCR.

Citations

• Associations between Fear of Cancer Recurrence and Health-Related Quality of Life, Psychological Distress, and Health Behaviors in Cancer Survivors
  Seo-Hee CHOI, Yeol KIM, Yu-Ri CHOE
  Korean Journal of Health Promotion.2025; 25(3): 99.     CrossRef
• Critical Considerations Regarding the Article “Association between Complementary and Alternative Medicine Use and Fear of Cancer Recurrence among Breast Cancer Survivors”
  Niloufar Johari Varnoosfaderani, Ehsan Amiri-Ardekani
  Korean Journal of Family Medicine.2023; 44(1): 66.     CrossRef
• Use of complementary and alternative medicine for reducing fear of cancer recurrence among cancer survivors: Does it work?
  Heliang Wu, Adnan Rashid Aziz, Mahlagha Dehghan, Leyla Ahmadi Lari, Rasmieh Al-Amer, Mohammad Ali Zakeri
  Asia-Pacific Journal of Oncology Nursing.2023; 10(10): 100278.     CrossRef
• Adherence to lifestyle recommendations among Norwegian cancer survivors and the impact of traditional and complementary medicine use: the Tromsø Study 2015–2016
  Kiwumulo Nakandi, Faith O. Benebo, Laila A. Hopstock, Trine Stub, Agnete E. Kristoffersen
  BMC Complementary Medicine and Therapies.2023;[Epub]     CrossRef