Social support, fear of cancer recurrence and sleep quality in breast cancer: A moderated network analysis

Purpose: Fear of cancer recurrence (FCR) contributes to sleep problems and social support is a buffering factor in the literature. However, the moderating effect of social support between FCR and sleep quality is unclear.

Methods: The moderating role of social support was examined in a cohort of 460 breast cancer patients from the 2024 Be Resilient to Breast Cancer (BRBC) program from a microscopic perspective using moderated network analysis, and then assessed macroscopically by Johnson-Neyman and response surface analysis. The Fear of Progression Questionnaire-Short Form, Perceived Social Support Scale and Pittsburgh Sleep Quality Index scale were employed in this study.

Results: Social support significantly moderated the relationship between general anxiety and sleep efficiency. General anxiety was positively correlated with sleep efficiency at high levels of social support (t = 3.774, P < 0.001). Patients with high social support and low FCR experienced better sleep (F = 6.166, P < 0.01).

Conclusion: Our study deepens the understanding of the association between FCR, social support, and sleep quality, and emphasizes social support as a positive strategy for cancer patients to improve their physical and mental health.