Medical Appointments are Associated with Same-Day Worry and Sleep Difficulties Among Cancer Survivors

Background: Symptoms of anxiety, including worry and sleep, can be exacerbated by impending medical appointments. These symptoms can impact cancer survivors’ ability to prepare for or process information during their appointments. Aims: The current study aimed to investigate how worry and sleep change during days or weeks prior to a medical appointment in individuals receiving active treatment for cancer or those in follow-up care. In addition, we examined how coping strategies are associated with fluctuations in worry and sleep around medical appointments. Methods: Participants with a history of cancer (N = 259, age M=49, 90.7% female, 84.2% non-Hispanic white) completed a baseline assessment, ecological momentary assessments, and weekly surveys for five weeks. We conducted a series of multi-level models to examine how appointment day, treatment status, and coping strategies, along with their interactions, predict daily worry and sleep. Results: On average, participants reported greater worry on days with (vs. without) a medical appointment, regardless of their coping strategies and treatment status. In addition, greater use of emotion suppression was associated with worse sleep quality the night before an appointment. Reduced sleep duration was also associated with greater use of suppression, but only among those in active treatment. Conclusions: Medical appointments are associated with worry and sleep difficulties among cancer survivors, but effects on sleep depend on stage in treatment and/or habitual use of suppression. Cancer survivors may benefit from strategies to manage appointment-related anxiety, with an emphasis on targeted interventions to improve adaptive coping strategies (rather than suppression).