Menopausal Symptoms, Depression, and Sleep Quality Among Postmenopausal Women With and Without Breast Cancer

It remains unclear whether sleep quality in breast cancer (BC) survivors is primarily driven by BC-specific or menopausal factors, due to limited comparisons with cancer-free women.

To compare sleep quality between postmenopausal BC survivors and healthy comparisons and to identify independent correlates of sleep quality across both groups.

A cross-sectional secondary analysis was performed using baseline data from 102 postmenopausal women (BC, n = 64; health comparison, n = 38). Sleep quality, menopausal symptoms, and depressive symptoms were measured using the Pittsburgh Sleep Quality Index (PSQI), Breast Cancer Prevention Trial Symptom Checklist, and Center for Epidemiologic Studies Depression Scale, respectively. Hierarchical multiple linear regression identified correlates of sleep quality.

Global PSQI scores were similar between groups. More than one-third (34.3%) were classified as poor sleepers (PSQI > 5). While most demonstrated adequate sleep latency (66.7%) and efficiency (74.5%), and subjective sleep quality (90.2%), only 25.5% achieved more than 7 hours per night. Employment (β = -0.21, P = .006), smoking (β = 0.18, P = .023), vasomotor symptoms (β = 0.22, P = .004), and depressive symptoms (β = 0.45, P < .001) together explained 54% of the variance in global PSQI. Musculoskeletal pain became nonsignificant after accounting for depressive symptoms.

BC survivorship was not associated with sleep quality. Vasomotor and depressive symptoms emerged as the primary correlates, regardless of cancer history.

Targeted interdisciplinary management of vasomotor and depressive symptoms, alongside routine sleep assessment, may enhance sleep outcomes in postmenopausal women.