Skip to main content

Advertisement

SpringerLink
Log in

Optimism outweighs neuroticism and anxiety sensitivity to predict insomnia symptoms in women after surgery for breast cancer

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Insomnia symptoms are common among women who have undergone surgery for breast cancer. Personality traits are also believed to have an impact on sleep. However, there are no reports to address the effects of personality traits on sleep in women with breast cancer. This study examined the separate and competing roles of neuroticism, anxiety sensitivity, and optimism in predicting post-surgery insomnia symptoms.

Methods

Women with breast cancer (n = 749) were enrolled the week prior to surgery and required to complete a demographic questionnaire, the Chinese version of Neuroticism subscale of NEO-Five Factor Inventory (CV-N-NEO-FFI), Anxiety Sensitivity Index-3 (CV-ASI-3), and Life Orientation Test-Revised (CV-LOT-R). Four weeks post-surgery, the Chinese version of Insomnia Severity Index (CV-ISI) was administered to evaluate insomnia symptoms.

Results

Neuroticism (β = 0.317, p < 0.001), anxiety sensitivity (β = 0.220, p < 0.001), and optimism (β = − 0.332, p < 0.001) could predict post-surgery insomnia symptoms. When putting them together into one stepwise regression, optimism (β = − 0.215, p < 0.001) became the statistically most important predictor for insomnia symptoms. Optimism suppressed the predictions of insomnia symptoms provided by neuroticism (β = 0.114, p < 0.001) and anxiety sensitivity (β = 0.079, p < 0.001).

Conclusion

Neuroticism and anxiety sensitivity positively predicted insomnia, but optimism negatively predicted insomnia. In particular, optimism plays a more important role in post-surgery insomnia symptoms in women with breast cancer compared to neuroticism and anxiety sensitivity. Sleep intervention in women with breast cancer should focus on enhancing their optimism level.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Onselen CV, Paul SM, Lee K, Dunn L, Aouizerat BE, West C, Dodd M, Cooper B, Miaskowski C (2013) Trajectories of sleep disturbance and daytime sleepiness in women before and after surgery for breast cancer. J Pain Symptom Manag 45:244–260

    Article  Google Scholar 

  2. Wang YP, Zhu XZ, Li LY, Yi JY, He JC (2016) What factors affect the insomnia symptom trajectories in women with nonmetastatic breast Cancer? J Pain Symptom Manag 52:850–858

    Article  Google Scholar 

  3. Onselen CV, Cooper BA, Lee K, Dunn L, Aouizerat BE, West C, Dodd M, Paul S, Miaskowski C (2012) Identification of distinct subgroups of breast cancer patients based on self-reported changes in sleep disturbance. Support Care Cancer 20:2611–2619

    Article  PubMed  Google Scholar 

  4. Bardwell WA, Profant J, Casden DR, Dimsdale JE, Ancoli-Israel S, Natarajan L, Rock CL, Pierce JP, Group WsHELWS (2008) The relative importance of specific risk factors for insomnia in women treated for early-stage breast cancer. Psycho-Oncol 17:9–18

    Article  Google Scholar 

  5. Luyster FS, Strollo PJ, Zee PC, Walsh JK (2012) Sleep: a health imperative. Sleep 35:727–734

    Article  PubMed  PubMed Central  Google Scholar 

  6. Millara K, Purushothamb AD, McLatchiec E, Georgec WD, Murray GD (2005) A 1-year prospective study of individual variation in distress, and illness perceptions, after treatment for breast cancer. J Psychosom Res 58:335–342

    Article  Google Scholar 

  7. Stafford L, Judd F, Gibson P, Komiti A, Mann GB, Quinn M (2015) Anxiety and depression symptoms in the 2 years following diagnosis of breast or gynaecologic cancer: prevalence, course and determinants of outcome. Support Care Cancer 23:2215–2224

    Article  PubMed  Google Scholar 

  8. Baglioni C, Spiegelhalder K, Lombardo C, Riemann D (2010) Sleep and emotions: a focus on insomnia. Sleep Med Rev 14:227–238

    Article  PubMed  Google Scholar 

  9. Harvey C-J, Gehrman P, Espie CA (2014) Who is predisposed to insomnia: a review of familial aggregation, stress-reactivity, personality and coping style. Sleep Med Rev 18:237–247

    Article  PubMed  Google Scholar 

  10. Jones SL, Hadjistavropoulos HD, Gullickson K (2014) Understanding health anxiety following breast cancer diagnosis. Psychol Health Med 19:525–535

    Article  PubMed  Google Scholar 

  11. Calkins AW, Hearon BA, Capozzoli MC, Otto MW (2013) Psychosocial predictors of sleep dysfunction: the role of anxiety sensitivity, dysfunctional beliefs, and neuroticism. Behav Sleep Med 11:133–143

    Article  PubMed  Google Scholar 

  12. Alcántara C, Cosenzo LAG, Fan W, Doyle DM, Shaffe JA (2017) Anxiety sensitivity and racial differences in sleep duration: results from a national survey of adults with cardiovascular disease. J Anxiety Disord 48:102–108

    Article  PubMed  Google Scholar 

  13. Leyro TM, Babson KA, Bonn-Miller MO (2014) Anxiety sensitivity in relation to sleep quality among HIV-infected individuals. J Assoc Nurses AIDS Care 25:638–645

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lemola S, Räikkönen K, Scheier MF, Matthews KA, Pesonen A-K, Heinonen K, Lahti J, Komsi N, Paavonen EJ, Kajantie E (2011) Sleep quantity, quality and optimism in children. J Sleep Res 20:12–20

    Article  PubMed  PubMed Central  Google Scholar 

  15. Conway F, Magai C, Springer C, Jones SC (2008) Optimism and pessimism as predictors of physical and psychological health among grandmothers raising their grandchildren. J Res Pers 42:1352–1357

    Article  Google Scholar 

  16. Lau EYY, Hui CH, Cheung S-F, Lam J (2015) Bidirectional relationship between sleep and optimism with depressive mood as a mediator: a longitudinal study of Chinese working adults. J Psychosom Res 79:428–434

    Article  PubMed  Google Scholar 

  17. Lau EYY, Hui CH, Lam J, Cheung S-F (2017) Sleep and optimism: a longitudinal study of bidirectional causal relationship and its mediating and moderating variables in a Chinese student sample. Chronobiol Int J Biol Med Rhythm Res 34:360–372

    Google Scholar 

  18. Levkvich I, Cohen M, Pollack S, Drumea K, Fried G (2015) Cancer-related fatigue and depression in breast cancer patients postchemotherapy: different associations with optimism and stress appraisals. Palliat Support Care 13:1–11

    Article  Google Scholar 

  19. Schou I, Ekeberg Ø, Ruland CM (2005) The mediating role of appraisal and coping in the relationship between optimism-pessimism and quality of life. Psycho-Oncol 14:718–727

    Article  CAS  Google Scholar 

  20. Ong AD, Kim S, Young S, Steptoe A (2017) Positive affect and sleep: a systematic review. Sleep Med Rev 35:21–32

    Article  PubMed  Google Scholar 

  21. Wood AM, Joseph S, Lloyd J, Atkins S (2009) Gratitude influences sleep through the mechanism of pre-sleep cognitions. J Psychosom Res 66:43–48

    Article  PubMed  Google Scholar 

  22. Armon G, Melamed S, Vinokur A (2014) The reciprocal relationship between vigor and insomnia: a three-wave prospective study of employed adults. J Behav Med 37:664–674

    Article  PubMed  Google Scholar 

  23. Sipila RM, Haasio L, Meretoja TJ, Ripatti S, Estlander A-M, Kalso EA (2017) Does expecting more pain make it more intense? Factors associated with the first week pain trajectories after breast cancer surgery. Pain 158:922–930

    Article  PubMed  PubMed Central  Google Scholar 

  24. Yao RS, Liang LY (2010) Analysis of the application of simplified NEO-FFI to undergraduates. Chin J Clin Psychol 18:457–459

    Google Scholar 

  25. Liu GH, Meng XZ (2011) Relationship between suicide probability and the big five personality in college freshmen. Chin J Clin Psychol 19:740–742

    Google Scholar 

  26. Xi C, Zhong MT, Lei XX, Liu Y, Ling Y, Yi JY (2017) Comparing the neuroticism subscale of the NEO-PI-R with that of the NEO-FFI. Chin J Clin Psychol 25:453–456

    Google Scholar 

  27. Wang YT, Zhu XZ, Tang LL, Wang YP, Li LY, Yang YL (2013) Reliability and validity of the Chinese Version of Anxiety Sensitivity Index-3(ASI-3) in Chinese women with breast Cancer. Chin J Clin Psychol 12:974–976

    Google Scholar 

  28. Taylor S, Cox BJ (1998) An Expanded Anxiety Sensitivity Index: Evidence for a Hierarchic Structure in a Clinical Sample. J Anxiety Disord 12:463–483

    Article  CAS  PubMed  Google Scholar 

  29. Li SC, Li LY, Zhu XZ, Wang YP, Zhang JQ, Zhao LP, Li LZ, Yang YJ (2016) Comparison of characteristics of anxiety sensitivity across career stages and its relationship with nursing stress among female nurses in Hunan, China. BMJ Open 6:e010829

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wang L, Liu WT, Zhu XZ, Wang YP, Li LY, Yang YL, George RA (2014) Validity and reliability of the Chinese Version of the Anxiety Sensitivity Index-3 in healthy adult women. Chin Ment Health J 28:767–771

    Google Scholar 

  31. Chan IWS, Lai JCL, Wong KWN (2006) Resilience is associated with better recovery in Chinese people diagnosed with coronary heart disease. Psychol Health 21:335–349

    Article  Google Scholar 

  32. Xia J, Wu DX, Zhang JB, Xu YC, Xu YX (2016) Chinese version of the Optimism and Pessimism Scale: psychometric properties in mainland China and development of a short form. J Health Psychol 21:983–993

    Article  PubMed  Google Scholar 

  33. Lai JCL (2009) Dispositional optimism buffers the impact of daily hassles on mental health in Chinese adolescents. Personal Individ Differ 47:247–249

    Article  Google Scholar 

  34. Scheier MF, Carver CS, Bridges MW (1994) Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the life orientation test. J Pers Soc Psychol 67:1063–1078

    Article  CAS  PubMed  Google Scholar 

  35. Lam WW, Chan M, Ka HW, Fielding R (2007) Treatment decision difficulties and post-operative distress predict persistence of psychological morbidity in Chinese women following breast cancer surgery. Psycho-Oncol 16:904–912

    Article  Google Scholar 

  36. Lam WW, Chan M, Hung WK, Or A, Fielding R (2009) Social adjustment among Chinese women following breast cancer surgery. Psycho-Oncol 18:1189–1198

    Article  Google Scholar 

  37. Shapour BA, Gang CK (2013) Reliability and validity of the Chinese Translation of Insomnia Severity Index and comparison with Pittsburgh Sleep Quality Index. Malays J Psychiatry 22(2):MJP-02-08-13

  38. Carver CS, Lehman JM, Antoni MH (2003) Dispositional pessimism predicts illness-related disruption of social and recreational activities among breast cancer patients. J Pers Soc Psychol 84:813–821

    Article  PubMed  Google Scholar 

  39. Garner MJ, McGregor BA, Murphy KM, Koenig AL, Dolan ED, Albano D (2015) Optimism and depression: a new look at social support as a mediator among women at risk for breast cancer. Psycho-Oncol 24:1708–1713

    Article  Google Scholar 

  40. Troxel WM, Buysse DJ, Monk TH, Begley A, Hall M (2010) Does social support differentially affect sleep in older adults with versus without insomnia. J Psychosom Res 69(5):459–466

    Article  PubMed  PubMed Central  Google Scholar 

  41. Wang YP, Zhu XZ, Yang YJ, Yi JY, Tang LL, He JC, Chen GN, Li LY, Yang YL (2015) What factors are predictive of benefit finding in women treated for non-metastatic breast cancer? A prospective study. Psycho-Oncol 24:533–539

    Article  Google Scholar 

  42. Matthews EE, Cook PF (2009) Relationships among optimism, well-being, self-transcendence, coping, and social support in women during treatment for breast cancer. Psycho-Oncol 18:716–726

    Article  Google Scholar 

  43. Wang YP, Zhu XZ, Yi JY, Tang LL, He JC, Chen GN, Li LY, Yang YL (2015) Benefit finding predicts depressive and anxious symptoms in women with breast cancer. Qual Life Res 24:2681–2688

    Article  CAS  PubMed  Google Scholar 

  44. Palesh O, Aldridge-Gerry A, Ulusakarya A, Ortiz-Tudela E, Capuron L, Innominato PF (2013) Sleep disruption in breast cancer patients and survivors. J Natl Compr Cancer Netw 11:1523–1530

    Article  Google Scholar 

  45. Palesh O, Aldridge-Gerry A, Zeitzer JM, Koopman C, Neri E, Giese-Davis J, Jo B, Kraemer H, Nouriani B, Spiegel D (2014) Actigraphy-measured sleep disruption as a predictor of survival among women with advanced breast cancer. Sleep 37:837–842

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This study was financially funded by the National Key Technologies R&D program in the 11th 5-year plan from the Ministry of Science and Technology (No. 2009BAI77B06) and National Natural Science Foundation of the People’s Republic of China (No. 81671341).

Author information

Authors and Affiliations

  1. Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China

    Yizhen Ren, Shichen Li, Shijie Zhou, Yuping Wang, Lingyan Li, Jinqiang Zhang & Xiongzhao Zhu

  2. Department of Medical Psychology, Public Health Institute, Harbin Medical University, Harbin, Heilongjiang, China

    Yanjie Yang

  3. The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China

    Jincai He

Authors
  1. Yizhen Ren
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shichen Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shijie Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuping Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lingyan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jinqiang Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yanjie Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jincai He
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Xiongzhao Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiongzhao Zhu.

Ethics declarations

This study was approved by the Ethics Committee of The Second Xiangya Hospital, Central South University in Hunan, China (reference number: 2010S177). From November 2013 to February 2016, eligible women at a hospital were informed of purposes of this research. Women who voluntarily participated in this research signed written informed consent.

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ren, Y., Li, S., Zhou, S. et al. Optimism outweighs neuroticism and anxiety sensitivity to predict insomnia symptoms in women after surgery for breast cancer. Support Care Cancer 27, 2903–2909 (2019). https://doi.org/10.1007/s00520-018-4610-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-018-4610-6

Keywords

Search

Navigation