Evidence map›Paper›PMID 41071122›Full record

ArticleSleep2026

Insomnia and elevated risk of major depressive disorder in older adult, long-term breast cancer survivors vs a matched cohort.

Michael R Irwin, Richard Olmstead, LieHong Chen, Reina Haque

Abstract read
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In one paragraph

Article in Sleep, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Michael R IrwinCousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
Richard OlmsteadCousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
LieHong ChenDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Reina HaqueDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.ORCID 0000-0001-8563-3330

Funding

Sleep, Inflamation, and Depression Occurrence in Breast Cancer SurvivorsR01CA160245 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI IRWIN, MICHAEL R · 2012 to 2016
$3.9M
Sleep Disturbance, Inflammation, and Cellular Aging in Breast Cancer SurvivorsR01CA207130 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI HAQUE, REINA, IRWIN, MICHAEL R · 2016 to 2020
$3.2M
NCI NIH HHS R01 CA160245NCI NIH HHS R01CA160245NCI NIH HHS R01 CA207130NCI NIH HHS R01CA207130
6 · The paper itself

Abstract

STUDY

objectivesDepression frequently occurs after diagnosis of breast cancer diagnosis. This study examines the incidence of depression and whether insomnia exaggerates depression risk in long-term breast cancer survivors (BCSs).

methodsA sample of 636 nondepressed females, aged 55 to 85 years, was recruited between 2015 and 2020 from a diverse community-based health plan; 315 were BCSs at least 2 years postdiagnosis, and 321 were an aged-matched comparison cohort. Both groups were stratified by the presence or absence of insomnia at baseline. The primary outcome, incident and recurrent major depressive disorder, was diagnosed over 32 months. Cox proportional hazards models estimated risk of depression (hazard ratio [HR], 95% confidence interval [CI]).

resultsA total of 310 (98.4%) BCSs, and 309 (96.3%) comparisons completed 32 months follow-up. Relative to the comparisons, risk of depression was elevated in BCSs (HR = 5.94; 95% CI = 3.34% to 10.54%, p < .001). Insomnia, as defined by the Insomnia Severity Index (>8), further increased depression risk BCS (HR = 9.91; 95% CI = 4.92% to 19.96%; p < .001), but not in the comparisons.

conclusionsLong-term BCSs have a heightened risk of major depressive disorder, and even subthreshold insomnia exaggerates that risk. Given that insomnia treatment can effectively prevent depression, insomnia screening and treatment have implications for depression prevention in BCSs. Statement of Significance Breast cancer survivors with insomnia show a markedly elevated risk of depression, which supports the urgent need to screen for insomnia in cancer survivors and to develop and implement insomnia treatment to prevent depression in this high-risk population.

Indexed as

Breast NeoplasmsCancer SurvivorsMajor Depressive DisorderSleep Initiation and Maintenance DisordersAgedAged, 80 and overCohort StudiesFemaleHumansIncidenceMiddle AgedRisk Factorsbreast cancerdepressioninsomniasurvivorship

Identifiers

PMID41071122
PMCPMC13396944

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.