Study on the Profiles of Sleep Disorders, Associated Factors, and Pathways Among Gynecological Cancer Patients – A Latent Profile Analysis

Figures & data

Figure 1 The theoretical basis of the mediating effect of perceived stress on stigma and sleep disorders.

Table 1 Distribution of the Sleep Disorders

Components	Frequency(n)	Percent(%)
Subjective sleep quality
Very good	37	18.3
Good	69	34.2
Poor	75	37.1
Very poor	21	10.4
Sleep latency
Very good	40	19.8
Good	98	48.5
Poor	60	29.7
Very poor	4	2.0
Sleep time
>7 hours	49	24.3
6–7 hours	47	23.3
5–6 hours	54	26.7
<5 hours	52	25.7
Sleep efficiency
>85%	86	42.6
75–84%	59	29.2
65–74%	22	10.9
<65%	35	17.3
Sleep disturbance
None	38	18.8
Occasional	83	41.1
Sometimes	56	27.7
Often	25	12.4
Sleep medication use
None	166	82.2
<1 time/week	25	12.4
1–2 times/week	7	3.5
≥3 times/week	4	2.0
Daytime dysfunction
None	88	43.6
Occasional	45	22.3
Sometimes, often	58	28.7
Often	11	5.4

Note: Bold text, the seven components of sleep disorders.

Table 2 Latent Class Model Fit Comparison

Models	AIC	BIC	aBIC	Entropy	LMR	BLRT	Class Probability(%)
1-class	3722.884	3769.199	3724.844
2-class	2896.144	2968.926	2899.225	0.956	<0.001	<0.001	58.2/41.8
3-class	2592.610	2691.858	2596.812	0.970	<0.001	<0.001	42.5/32.4/25.1
4-class	2450.500	2576.215	2455.823	0.976	0.0011	<0.001	32.0/20.1/42.5/5.4
5-class	2319.915	2472.095	2326.358	0.985	0.6672	<0.001	24.0/19.8/25.0/25.7/5.4

Figure 2 Latent profile plot based on the sleep disturbance for patients with gynecological cancer.

Table 3 Differences in Demographic and Clinical Characteristics Among the Latent Classes (n, %)

Variable	Good Sleep Group	Sleep Deficiency Group	Sleep Disturbance Group	χ^2	P
Marital status				4.080	0.130
Married/cohabited	76(37.6%)	63(31.2%)	43(21.3%)
Single/separated	9(4.5%)	3(1.5%)	8(4.0%)
Monthly family income				6.430	0.169
≤2000CNY	22(10.9%)	25(12.4%)	9(4.5%)
2001–4000CNY	31(15.3%)	19(9.4%)	22(10.9%)
>4000CNY	32(42.1%)	22(10.9%)	20(9.9%)
Education level				2.465	0.651
Middle school or under	45(22.3%)	40(19.8%)	30(14.9%)
High or secondary school	33(16.3%)	24(11.9%)	17(8.4%)
Undergraduate or above	7(3.5%)	2(1.0%)	4(2.%)
Exercise frequency				15.217	0.004
Never	13(6.4%)	21(10.4%)	20(9.9%)
1–2 times/week	35(17.3%)	29(14.4%)	21(10.4%)
≥3 times/week	37(18.3%)	16(7.9%)	10(5.0%)
Residence				4.375	0.112
Urban area	52(25.7%)	37(18.3%)	38(18.8%)
Rural area	33(16.3%)	29(14.4%)	13(6.4%)
Regularly drinking coffee				0.026	0.987
No	76(37.6%)	59(29.2%)	46(22.8%)
Yes	9(4.5%)	7(3.5%)	5(2.5%)
Hypertension				2.938	0.230
No	74(36.6%)	52(25.7%)	39(19.3%)
Yes	11(5.4%)	14(6.9%)	12(5.9%)
Stage of cancer				6.437	0.169
StageI	23(11.4%)	19(9.4%)	9(4.5%)
StageII	25(12.4%)	16(7.9%)	9(4.5%)
StageIII+IV	37(18.3%)	31(15.3%)	33(16.3%)

Table 4 Differences in Continuous Variables Among the Latent Classes (Mean±SD)

	Good Sleep Group	Sleep Deficiency Group	Sleep Disturbance Group	F	P
Age	54.27±9.67^a	55.37±9.12^b	59.04±10.78^ab	3.889	0.022
BMI	23.46±2.84	23.94±2.88	24.31±2.76	1.482	0.230
Perceived Stress	11.18±5.44^a	14.92±5.48^a	22.54±7.08^a	59.052	<0.001
Self-stigma	37.33±11.18^a	40.24±11.30^b	48.45±15.19^ab	13.165	<0.001

Note: ^a,bThe Least-Significant Difference showed statistical differences between two groups with the same letter.

Table 5 Factors in Differentiating Distinct PSQI Groups

Variables	Sleep Deficiency Group				Sleep Disturbance Group
	B	OR	95% CI	P	B	OR	95% CI	P
Age	0.013	1.013	0.978–1.049	0.465	0.078	1.082	1.026–1.140	0.004
Exercise frequency
Never	1.341	3.824	1.460–10.011	0.006	2.083	8.028	1.885–34.188	0.005
1–2 times/week	0.490	1.632	0.719–3.704	0.242	1.420	4.135	1.121–15.255	0.003
Perceived Stress	0.133	1.142	1.061–1.230	<0.001	0.375	1.455	1.291–1.640	<0.001
Self-stigma	−0.007	0.993	0.960–1.028	0.698	−0.007	0.993	0.950–1.038	0.993

Figure 3 The mediation model of perceived stress in self-stigma and sleep disorders.

Note: **P<0.01.

Table 6 The Mediating Effect Test of Perceived Stress

Effects	Effect Value	95% CI
Indirect effects	0.172**	0.101	0.172
Direct effects	0.055	−0.054	0.055
Total effects	0.182**	0.084	0.182

Note: **P<0.01.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.