Abstract B054: Impact of health behaviors, health outcomes, and socioeconomic status on sleep duration among gynecologic cancer survivors
Authors: Rolle LaShae D. , Chery Maurice J. , Mercadel Alyssa , Schlumbrecht Matthew P. , George Sophia H.L. , Crane Tracy E. 
Published: December 2023

Abstract
Background: Emerging evidence suggests sleep duration may be associated with health outcomes among cancer survivors. There have been few studies analyzing sleep among gynecologic cancer survivors (GCS). We defined GCS as respondents who reported being told they had a form of gynecologic cancer (cervical, endometrial, and ovarian cancer) in their life. This study aimed to explore the associations between health outcomes, health behaviors, and socioeconomic status (SES) on sleep duration in GCS. Methods: We used the 2016-2020 Behavioral Risk Factor Surveillance System (BRFSS) datasets to evaluate the impacts of health outcomes, health behaviors, and SES on sleep duration among GCS. We categorized sleep duration into Short Sleep Duration (&lt;7 hours) (SSD), Long Sleep Duration (&gt;8 hours) (LSD), and Optimal Sleep Duration (7-8 hours) (OSD). Bivariate analyses including chi-square tests, were used to examine associations between health outcomes, behaviors, SES, and sleep duration. A multivariable ordinal logistic regression model was produced to assess the adjusted odds ratios (aOR) for sleep duration, considering health outcomes, behaviors, and SES, while controlling for confounders. Results: Our sample (N=10222) was primarily composed of cervical (n=8856) followed by endometrial (n=1198) and ovarian (n=168) cancer survivors. Most of the sample was 65+ years old (65.93%), followed by the age categories 40-64 years old (32.17%) and 18-39 years old (1.90%). Regarding race, most of the sample was non-Hispanic White (95.68%), followed by non-Hispanic Black (2.54%) and Hispanic (1.78%). We found significant associations between health outcomes, health behaviors, and SES in relation to sleep duration among GCS. GCS who reported depression had higher odds of both LSD (aOR=1.93, 95% CI: 1.45-2.58) and SSD (aOR=1.57, 95% CI: 1.29-1.92). GCS engaging in exercise were more likely to report LSD (aOR=1.53, 95% CI: 1.15-2.04). Current smokers had an increased likelihood of SSD (aOR=1.47, 95% CI: 1.11-1.95). Unemployment was associated with an increased likelihood of LSD (aOR=2.67, 95% CI: 1.87-3.82). Additionally, GCS with incomes &lt;$25,000 had significantly higher odds of SSD compared to GCS earning &gt;$75,000 (aOR=1.82, 95% CI: 1.38-2.39). For health outcomes, GCS with fair/poor health were significantly more likely to report SSD compared to GCS with excellent health (aOR=1.63, 95% CI: 1.20-2.20). GCS experiencing 14 or more poor health days in a month also had higher odds of SSD (aOR=1.31, 95% CI: 1.11-1.55). Finally, GCS residing in rural areas had an association with SSD (aOR=1.22, 95% CI: 1.03-1.44) in comparison to GCS residing in urban areas. Discussion: Our findings illustrate a complex interplay of health outcomes, health behaviors, and SES contributing to sleep duration among GCS. This underscores the crucial need to address sleep duration to improve health outcomes, reduce disparities, and increase quality of life for all GCS. Opportunities for future research include sleep hygiene interventions that may mitigate these effects and improve sleep among GCS.
Citation Format: LaShae D. Rolle, Maurice J. Chery, Alyssa Mercadel, Matthew P. Schlumbrecht, Sophia H.L. George, Tracy E. Crane. Impact of health behaviors, health outcomes, and socioeconomic status on sleep duration among gynecologic cancer survivors [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B054.