The Level of Psychological Distress Is Associated With Circadian Rhythm, Sleep Quality, and Inflammatory Markers in Adolescent and Young Adults With Gynecological Cancer

Abstract

Background Adolescent and young adult (AYA) patients with cancer commonly experience psychological distress, with female patients experiencing higher levels of psychological distress. Objective The aim of this study was to investigate the relationships among circadian rhythm, sleep quality, inflammatory markers, and psychological distress in AYA patients with gynecological cancer in China. Methods This cross-sectional study enrolled 75 AYA patients in treatment for gynecological cancer, 64 of whom completed the Chinese version of the Morningness-Eveningness Questionnaire and the Distress Thermometer. Actigraphy was used to measure their objective sleep parameters: total sleep time, sleep onset latency, and sleep efficiency. Blood samples collected 3 times across 1 day were used to measure the average levels of interleukin 6, C-reactive protein, and tumor necrosis factor α. Results The mean score on the Distress Thermometer among respondents was 4.23, which was above the cutoff value for clinically significant psychological distress. High levels of psychological distress may be associated with circadian disturbances, poor sleep quality, and elevated inflammatory markers. In addition, total sleep time, sleep onset latency, and tumor necrosis factor α averages were the dominant predictors of these AYA patients’ psychological distress. Conclusion Improving sleep quality and reducing the levels of inflammatory markers may relieve psychological distress among AYA patients with gynecological cancer. Implications for Practice Healthcare professionals need to actively focus on circadian rhythm, inflammatory markers, sleep quality, and mental health status in AYA cancer patients to better meet their therapeutic and psychological needs.