Association of insomnia with anxiety might be greater than that of depression among patients with gastrointestinal cancer: a network analysis

Patients with gastrointestinal cancer frequently encounter a myriad of sleep disorders, and these disturbances can profoundly exacerbate their psychological distress, particularly anxiety and depression. Elucidating the intricate relationship between sleep disorders and psychological disturbances holds paramount significance in enhancing the therapeutic efficacy and improving the survival outcomes for these patients. A cross-sectional study including 352 participants from two hospitals was conducted. Insomnia symptoms and psychological distress were assessed. Pearson correlation analysis and network analysis were used to determine the association between insomnia and psychological distress components. In this study, the prevalence of psychological distress was recorded at 45.2%, while the prevalence of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) stood at 37.5%, 34.9%, and 46.9%, respectively. The partial correlation showed the strongest correlation was observed between DIS and anxiety, with a coefficient of 0.15 (0.00, 0.23), and no direct conditional association was observed between depression and any of the insomnia symptoms within the network analyzed. Emphasizing the crucial role of difficulty initiating sleep (DIS) in relation to anxiety deepens our understanding of the intricate interplay between physical and mental symptoms experienced by gastrointestinal cancer patients. By recognizing and comprehending these interconnected factors, healthcare professionals can devise more tailored therapeutic strategies, ultimately contributing to enhanced overall patient outcomes.