目的是在癌症幸存者治疗后前两年内检查睡眠障碍的轨迹，以及研究心理、认知和身体因素是否能区分不同的轨迹。在癌症治疗完成后，共有623名中国不同癌症类型的癌症幸存者参与了为期两年的前瞻性研究。采用匹兹堡睡眠质量指数（PSQI）测量睡眠障碍，检查了基线（治疗后6个月内；T1）、3个月（T2）、6个月（T3）、12个月（T4）、18个月（T5）和24个月（T6）时的睡眠质量。采用潜在增长混合模型确定不同的睡眠障碍轨迹，并测试这些纵向模式是否由基线心理困扰、注意力控制、注意力偏向和身体症状困扰以及T2期癌症相关困扰所预测。通过充分调整的多项逻辑回归分析确定这些因素是否能区分不同的睡眠障碍轨迹。研究发现，有两种不同的睡眠障碍轨迹，即稳定的好睡眠者（69.7%）和持续高睡眠障碍者（30.3%）。与稳定好睡眠组相比，持续高睡眠障碍组的患者更少报道避免（OR=0.49，95% CI=0.26-0.90），更可能抱有侵入性的想法（OR= 1.76，95% CI=1.06-2.92）和癌症相关的高度兴奋（OR= 3.37，95% CI=1.78-6.38）。较高的抑郁症状也预测了患者属于持续高睡眠障碍组的可能性（OR=1.13，95% CI=1.03-1.25）。然而，注意偏向、注意力控制、焦虑和身体症状困扰并未能预测睡眠障碍轨迹成员资格。三分之一的癌症幸存者经历了持续高睡眠障碍。筛查及管理在早期的癌症康复期间的抑郁症状和癌症相关困扰，可能会减少癌症幸存者持续睡眠障碍的风险。

To examine the trajectories of sleep disturbance in cancer survivors during the first two years post-treatment and to investigate whether psychological, cognitive and physical factors differentiate trajectories.A total of 623 Chinese cancer survivors of diverse cancer types participated in a 2-year-long prospective study after completion of cancer treatment. Sleep disturbance was measured using Pittsburgh Sleep Quality Index (PSQI) at 3 (T2), 6 (T3), 12 (T4), 18 (T5) and 24 (T6) months after baseline (within 6-months post-treatment; T1). Latent growth mixture modelling identified distinctive sleep disturbance trajectories and tested if these longitudinal patterns were predicted by baseline psychological distress, attentional control, attentional bias and physical symptom distress and T2 cancer-related distress. Fully-adjusted Multinomial Logistic Regression then identified whether these factors differentiated trajectories.Two distinct sleep disturbance trajectories were identified, namely stable good sleepers (69.7%) and persistent high sleep disturbance (30.3%). Compared to those in the stable good sleep group, patients in the persistent high sleep disturbance group were less likely to report avoidant (OR=0.49, 95% CI=0.26-0.90), while more likely to report intrusive thoughts (OR= 1.76, 95% CI=1.06-2.92) and cancer-related hyperarousal (OR= 3.37, 95% CI=1.78-6.38). Higher depression scores also predicted persistent high sleep disturbance group membership (OR=1.13, 95% CI=1.03-1.25). Attentional bias, attentional control, anxiety and physical symptom distress did not predict sleep trajectory membership.One in three cancer survivors experienced persistent high sleep disturbance. Screening and managing depressive symptoms and cancer-related distress in early cancer rehabilitation may reduce risk of persistent sleep disturbance among cancer survivors.© The Author(s) 2023. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.