Phipps, Amanda IDonzella, Sidney M2025-10-022025-10-022025Donzella_washington_0250E_28689.pdfhttps://hdl.handle.net/1773/54018Thesis (Ph.D.)--University of Washington, 2025Sleep is a multidimensional lifestyle behavior essential to human life. Unlike some lifestyle behaviors, sleep is a behavior practiced by all humans, making it a desirable lifestyle behavior to target for disease prevention and survivorship interventions. Prior research elucidating the bidirectional relationship between sleep and cancer has been limited. The objective of this dissertation was to understand how several dimensions of sleep (e.g., duration, timing, regularity) relate to cancer risk, and how the diagnosis of cancer changes subsequent sleep patterns. We leveraged data from the Cancer Prevention Study – 3, a prospective cohort of approximately 250,000 US adults aged 30-65 years at baseline. Sleep parameters were collected at baseline (2006-2013), 2015, and 2018. Cancer incidence was determined via linkage to state registries; follow-up time ended at the time of cancer diagnosis, time of death, or end of follow-up (12/31/2018). In Aim 1, we investigated the association of sleep duration and weekend catch-up sleep with cancer risk. In Aim 2, we investigated the association of sleep midpoint and social jetlag (i.e., difference between midsleep time on weekdays and weekends) with cancer risk. In Aim 3, we investigated how sleep duration changes following a cancer diagnosis. Collectively, findings from this dissertation identified social jetlag as being associated with cancer risk, with no evidence of consistent associations for other examined sleep dimensions. We also observed that sleep duration increased after a diagnosis of cancer, after accounting for prior sleep duration patterns and anticipated age-related changes. Findings from this dissertation provide robust information that may inform future cancer prevention and cancer survivorship guidelines.application/pdfen-USnonePublic healthEpidemiologyThesis