Dyadic Associations Between Stress and Sleep Quality and Moderating Effects of Emotional Intimacy and in Survivors of Young Adult Cancer and Their Spouses: An Observational Study.

backgroundSurvivors of young adult (YA) cancer often experience substantial stress during the transition to survivorship, which may impair sleep. Although the stress-sleep link is well established, its role within survivor-spouse dyads remains unclear. Emotional intimacy may influence how couples regulate stress and affect sleep. This study examined dyadic associations between stress and sleep among survivors of YA cancer and their spouses and significant others (hereafter spouses) and tested emotional intimacy as a moderator.

methodsA total of 103 survivor of YA cancer-spouse dyads completed self-reported measures of stress, emotional intimacy, and sleep quality. An actor-partner interdependence moderation model was used to test how each person's stress was related to their own and their spouse's sleep quality and the moderating role of emotional intimacy.

resultsIn our model, higher stress was associated with poorer sleep quality among both survivors (β = 0.405, p < 0.001) and spouses (β = 0.172, p = 0.041), indicating significant actor effects, whereas no partner effects from stress were observed. Emotional intimacy moderated the stress-sleep association among survivors (β = -0.224, p = 0.004), but not among spouses (β = -0.012, p = 0.892).

conclusionsStress emerged as a key intrapersonal determinant of sleep quality for both survivors of young adult cancer and their spouses, indicating that stress management may benefit sleep in both groups. Emotional intimacy buffered stress-related sleep disruption among survivors, but not spouses, highlighting role-specific mechanisms. Tailored approaches may improve sleep and quality of life.