title: Sleep quality and depressive symptoms after prostate cancer: The mechanistic role of cortisol.
abstract: A substantial portion of men treated for prostate cancer report clinically significant sleep problems and disturbance in sleep quality constitutes significant risk for the development of depressive symptoms in survivors. Dysregulation in biological stress processes underlies the impact of poor sleep on the onset and/or progression of depressive symptoms, yet few studies have sought to identify potential neurobiological mechanisms (e.g., HPA axis activation) underlying this association in PC survivors. The present study examines the relationships between sleep disturbance, depressive symptoms, and indices of diurnal cortisol patterns among men treated for prostate cancer. In total, 66 men (84.8% White; mean age = 65.8 years, SD = 9.04) treated in the prior 2 years for localized prostate cancer were recruited. They completed questionnaires to measure sleep quality and depressive symptoms at study entry (T1) and 4 months later (T2). They also provided 4 saliva samples per day, over 3 days, at T1. Three cortisol indices were computed: diurnal slope, area under the curve (AUCg), and cortisol awakening response (CAR). Analyses indicate that, controlling for body mass index and age, worse sleep quality at T1 was significantly associated with higher levels of depressive symptoms at T2. Significant indirect effects were observed for cortisol slope (indirect effect = -.17, 95% CI [-.61, -.01]) and AUCg (indirect effect = -.14, 95% CI [-.43, -.01]), but not CAR. Results suggest that dysregulation in HPA activity acts as a neurobiological mechanism of the impact of sleep disruption on depressive symptoms in men with prostate cancer. (PsycINFO Database Record
authors.affiliation: Department of Psychology, Graduate Center, Hunter College, City University of New York.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Hoyt
authors.affiliation: Department of Psychology, Cousins Center for Psychoneuroimmunology, Semel Institute, University of California, Los Angeles.
authors.forename: Julienne E
authors.initials: JE
authors.lastname: Bower
authors.affiliation: Department of Psychology, Cousins Center for Psychoneuroimmunology, Semel Institute, University of California, Los Angeles.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
authors.affiliation: Department of Psychology, Graduate Center, Hunter College, City University of New York.
authors.forename: Mariann R
authors.initials: MR
authors.lastname: Weierich
authors.affiliation: Department of Psychology, Cousins Center for Psychoneuroimmunology, Semel Institute, University of California, Los Angeles.
authors.forename: Annette L
authors.initials: AL
authors.lastname: Stanton
mesh_terms: D000368:Aged; D002940:Circadian Rhythm / Q000502:physiology; D003863:Depression / Q000523:psychology*; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000378:metabolism; D008297:Male; D011471:Prostatic Neoplasms / Q000150:complications*; D007319:Sleep Initiation and Maintenance Disorders / Q000378:metabolism; D011795:Surveys and Questionnaires
chemical_list: D006854:Hydrocortisone
references.citation: J Natl Cancer Inst. 2000 Jun 21;92(12):994-1000
references.pmid: 10861311
references.citation: Mol Psychiatry. 2015 Feb;20(1):32-47
references.pmid: 25486982
references.citation: Health Psychol. 2002 Nov;21(6):531-41
references.pmid: 12433005
references.citation: Psychoneuroendocrinology. 2003 Oct;28(7):916-31
references.pmid: 12892658
references.citation: Psychiatry Res. 1989 May;28(2):193-213
references.pmid: 2748771
references.citation: Psychoneuroendocrinology. 1997 Feb;22(2):89-105
references.pmid: 9149331
references.citation: J Psychosom Res. 1998 Jul;45(1):5-13
references.pmid: 9720850
references.citation: Psychooncology. 2005 Feb;14(2):147-56
references.pmid: 15386779
references.citation: J Pain Symptom Manage. 2005 Nov;30(5):474-84
references.pmid: 16310621
references.citation: Nat Rev Cancer. 2006 Mar;6(3):240-8
references.pmid: 16498446
references.citation: Cancer. 2006 Dec 1;107(11):2723-9
references.pmid: 17036362
references.citation: J Behav Med. 2007 Feb;30(1):45-58
references.pmid: 17245618
references.citation: J Clin Oncol. 2008 Feb 10;26(5):768-77
references.pmid: 18258985
references.citation: Behav Res Methods. 2008 Aug;40(3):879-91
references.pmid: 18697684
references.citation: J Clin Oncol. 2008 Oct 10;26(29):4820-7
references.pmid: 18779606
references.citation: Biol Psychol. 2009 Mar;80(3):265-78
references.pmid: 19022335
references.citation: Appl Nurs Res. 2009 Aug;22(3):154-8
references.pmid: 19616162
references.citation: Psychoneuroendocrinology. 2009 Nov;34(10):1423-36
references.pmid: 19647372
references.citation: Brain Behav Immun. 2009 Nov;23(8):1148-55
references.pmid: 19643176
references.citation: Neurosci Biobehav Rev. 2010 Sep;35(1):97-103
references.pmid: 20026350
references.citation: Sleep. 2011 Feb;34(2):171-9
references.pmid: 21286498
references.citation: Psychosom Med. 2011 Feb-Mar;73(2):114-26
references.pmid: 21257974
references.citation: Psychosom Med. 2011 Nov-Dec;73(9):724-30
references.pmid: 22021459
references.citation: Pflugers Arch. 2012 Jan;463(1):121-37
references.pmid: 22071480
references.citation: Psychoneuroendocrinology. 2012 Jul;37(7):1029-38
references.pmid: 22196046
references.citation: PLoS One. 2012;7(8):e42324
references.pmid: 22870317
references.citation: Cancer Epidemiol Biomarkers Prev. 2012 Nov;21(11):2076-86
references.pmid: 23136255
references.citation: Brain Behav Immun. 2013 Mar;30 Suppl:S58-67
references.pmid: 22634367
references.citation: Brain Behav Immun. 2013 Mar;30 Suppl:S19-25
references.pmid: 22728325
references.citation: Brain Behav Immun. 2013 Mar;30 Suppl:S163-70
references.pmid: 22884416
references.citation: Psychoneuroendocrinology. 2013 Oct;38(10):2337-42
references.pmid: 23742786
references.citation: Psychoneuroendocrinology. 2013 Nov;38(11):2720-8
references.pmid: 23890985
references.citation: Prog Neuropsychopharmacol Biol Psychiatry. 2013 Dec 2;47:69-76
references.pmid: 23969030
references.citation: Brain Behav Immun. 2015 Feb;44:137-47
references.pmid: 25241020
references.citation: Annu Rev Psychol. 2015 Jan 3;66:143-72
references.pmid: 25061767
references.citation: J Clin Oncol. 2001 Feb 1;19(3):895-908
references.pmid: 11157043