Sleep Quality Moderates the Impact of Place-Based Social Adversity on Physical Health in Women with Breast Cancer Transitioning from Active Treatment to Survivorship

Abstract

Social adversity is linked to poorer physical health in breast cancer survivors, highlighting the urgency of addressing health equity. Simultaneously, identifying individual-level factors that mitigate these effects may provide more immediate relief for survivors. This study examined whether four modifiable psychosocial factors—emotion dysregulation, physical activity, sleep disturbance, and social support—moderate the relationship between place-based social adversity and physical health in 255 breast cancer survivors (Mage = 56.03, 74.5% non-Hispanic White) within six months post-treatment. Linear regression analyses with 5000 bootstrapped estimates revealed that sleep disturbance significantly moderated the relationship between place-based social adversity and physical health (B = −0.014, SE = 0.001, bootstrapped 95% CI = −0.027, −0.001). Specifically, greater place-based social adversity was associated with poorer physical health at high levels of sleep disturbance (B = −0.22, p = 0.004), but not at low (B = 0.01, p = 0.94) or average (B = −0.10, p = 0.07) levels. Emotion dysregulation, physical activity, and social support did not moderate this relationship. Findings suggest that improving sleep quality may buffer the negative impact of social adversity on physical health, identifying sleep as a potential target for interventions aimed at reducing disparities among breast cancer survivors.