Sleep disorders are unrelated with obesity in survivors of colorectal cancer

November 2021 Science Nalinee Pathak

Colorectal cancer (CRC) is one of the most common cancers diagnosed both in men and women. The incidence of CRC with patients’ diet behaviour, physical activity, and obesity has been examined by many groups over the years. In recent years, studies have also focused on the question if sleep duration is correlated with the incidence of developing CRC. It is well known that short sleep duration and poor sleep quality is associated with obesity and an unhealthy diet in the general population. Winter et al have recently investigated if such an association of sleep quality and duration with obesity and quality of diet exists in CRC survivors.

Study design

The researchers carried out a longitudinal observational study on 1002 CRC survivors who were 4-13 years post-diagnosis. Quality of diet was scored as low, moderate, or high based on the recommendations of the 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR). These recommendations are based on screening the diet on five parameters: fruit and vegetables, dietary fiber, red and processed meat, alcoholic beverages, and sugary drinks. Obesity measures like body mass index (BMI) and waist circumference (WC) were self-measured. Sleep quality and sleep duration were measured using the Pittsburgh Sleep Quality Index (PSQI). Statistical analyses such as multivariable linear and multinomial logistic regression analyses was done for analyzing these associations.

Main finding

Among all the survivors whose sleep parameters were assessed, a quarter of patients (25%) had poor sleep quality with PSQI score less than/equal to 8. Also, 24% of patients had a shorter duration of sleep (≤ 6 h). However, the study did not find any association between sleep and parameters of obesity (BMI, WC, and diet quality) among CRC survivors.


Sleep disorders are associated with BMI, WC, and diet quality in the general population. Sleep problems are also commonly observed in long-term CRC survivors.  However, the longitudinal study on 1002 CRC survivors did not see any association between sleep disorders and obesity parameters in this population. Future studies are needed to explore the reasons behind this variation between CRC survivors and the general population. 


de Winter J, Ezendam NPM, Bours MJL, Winkels RM, Weijenberg MP, Kampman E, et al. Is sleep associated with BMI, waist circumference, and diet among long-term  colorectal cancer survivors? Results from the population-based PROFILES registry. Support care cancer  Off J Multinatl Assoc  Support Care Cancer. 2021 Dec;29(12):7225–35.