The evolution of secondary insomnia in women with breast cancer

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University of Alabama Libraries

Secondary insomnia resulting from the onset of a health problem often persists beyond the course of the instigating stressor, suggesting that secondary insomnia evolves into a self-sustaining primary disorder. However, the course of secondary insomnia and how it relates to a primary medical or psychological disorder is poorly understood. Newly diagnosed breast cancer provides an opportunity to study secondary insomnia at the onset of an instigating stressor. The current study explored the feasibility of a methodology to examine the relationship between insomnia and breast cancer over a 2 month period in 29 women newly diagnosed (< 6 weeks) with breast cancer. Primary analyses included exploratory descriptive techniques. A multilevel modeling framework was also applied to the data to examine changes in sleep and cancer symptoms over time. The results show a significant relationship between insomnia severity and breast cancer symptom severity. Evidence is also presented regarding differences in the experience of this relationship for individuals with primary and secondary insomnia. Further evidence is presented supporting a change in the relationship between sleep and stress over time for individuals with secondary insomnia. Implications for timing of intervention and future research are discussed.

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