IMR Press / JOMH / Volume 17 / Issue 3 / DOI: 10.31083/jomh.2021.033
Open Access Original Research
The influence of education level on sleep-related outcomes and sleep management strategies in prostate cancer patients
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1 Department of Anatomy, University of Otago, 270 Great King St, 9016 Dunedin, New Zealand
2 WellSleep, Department of Medicine, University of Otago, Wellington, New Zealand
*Correspondence: (Erik Wibowo)
J. Mens. Health 2021, 17(3), 60–68;
Submitted: 29 January 2021 | Accepted: 4 March 2021 | Published: 8 July 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (

Introduction: Insomnia symptoms are common among prostate cancer (PCa) patients. We explore here whether education level is associated with sleep-related outcomes, and preference for sleep management strategies.

Methods: A short online survey was posted on Facebook with the help of Prostate Cancer Foundation New Zealand. The survey consisted of scales on sleep-related parameters, as well as questions about sleep management strategies.

Results: Demographic data were similar between participants with (n = 49) and without (n = 32) university education. Participants with no university education were more likely to receive external beam radiation (P = 0.035) than participants without university education. In addition, those without university education also had significantly more comorbidities (P = 0.046), higher body mass index (P = 0.048), and more severe fatigue (P = 0.031) but similar levels of insomnia symptoms (P = 0.50), sleepiness (P = 0.36) and morningness-eveningness (P = 0.07) than those with university education. After controlling for age, number of comorbidities, and insomnia severity, lower education was associated with lower likelihood of having used herbal remedies or supplements for improving sleep (OR = 0.208, P = 0.041). Education level is not related to the use of sleep medication, cognitive behaviour therapy, mindfulness, acupuncture, hypnosis for sleep management in PCa patients.

Conclusion: Education level is not associated with insomnia symptoms, but with fatigue level and the use of herbal remedies or supplements for sleep management in PCa patients.

Prostate cancer
Management strategies
Treatment side effects
Fig. 1.
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