我们在一群年轻乳腺癌患者中研究了失眠的纵向趋势和相关因素，为期3年。我们在纽约、得克萨斯和北卡罗来纳的五家机构中招募了8个月内确诊的I-III期乳腺癌患者（n = 836）。参与者每6个月填写一次问卷，为期3年。我们使用Women's Health Initiative Insomnia Rating Scale（WHIIRS）的线性混合效应模型来研究失眠随时间的变化。我们评估了失眠与人口统计学特征（年龄、种族、教育、收入、就业、婚姻状况）、临床特征（癌症分期、组织学分级、化疗、放射治疗、激素治疗、手术、肿瘤大小、体重指数、潮热症状）以及社会行为变量（吸烟状态、社会支持、体力活动、抑郁症状）的关系。在基线时，57%的参与者满足或超过了临床失眠的切点（WHIIRS分数≥9）。失眠症状在基线时最为普遍（p < 0.0001），但在随访中显著下降（p < 0.001）。然而，42%的参与者在确诊3年后仍然出现失眠症状。在多变量模型中，年龄较大（p = 0.02）、潮热症状（p < 0.0001）和抑郁症状（p < 0.0001）与失眠症状随时间保持相关。失眠症状在乳腺癌诊断和治疗阶段最为频繁，但对于一些年龄较大、潮热症状和抑郁症状较严重的女性仍然持续存在。在乳腺癌幸存者的护理中应该评估失眠症状，特别是在主要治疗过程中和立即之后。对睡眠问题实施早期干预可能有助于年轻乳腺癌幸存者，提高其生活质量。© 2023. 作者。

We examined longitudinal trends and factors associated with insomnia over 3 years in a cohort of young breast cancer patients.Women with stage I-III breast cancer at ≤ 45 years were recruited at five institutions from New York, Texas, and North Carolina, within 8 months of diagnosis (n = 836). Participants completed questionnaires every 6 months for 3 years. Linear mixed-effects models were used to examine insomnia over time, using the Women's Health Initiative Insomnia Rating Scale (WHIIRS). We evaluated the relations of insomnia with demographic (age, race, education, income, employment, marital status), clinical (cancer stage, histologic grade, chemotherapy, radiation, hormone therapy, surgery, tumor size, body mass index, hot flashes), and social/behavioral variables (smoking status, social support, physical activity, depressive symptoms).At baseline, 57% of participants met or exceeded the cut-off for clinical insomnia (WHIIRS score ≥ 9). Insomnia symptoms were most prevalent at baseline (p < 0.0001), but decreased significantly throughout follow-up (p < 0.001). However, 42% of participants still experienced insomnia symptoms 3 years after diagnosis. In multivariable models, older age (p = 0.02), hot flashes (p < 0.0001), and depressive symptoms (p < 0.0001) remained significantly associated with insomnia over time.Insomnia symptoms were most frequent closer to breast cancer diagnosis and treatment, but persisted for some women who were older and those reporting higher hot flashes and depressive symptoms. Survivorship care should include assessing insomnia symptoms, particularly during and immediately after primary treatment. Implementing early interventions for sleep problems may benefit young breast cancer survivors and improve their quality of life.© 2023. The Author(s).