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Little data exist about the impact of the pandemic on sleep and mental health among older women with breast cancer. We sought to examine whether women with and without breast cancer who experienced new sleep problems during the pandemic had worsening depression and anxiety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Breast cancer survivors aged \u226560\u00a0years with a history of nonmetastatic breast cancer (<jats:italic>n<\/jats:italic>\u00a0=\u00a0242) and frequency\u2010matched noncancer controls (<jats:italic>n<\/jats:italic>\u00a0=\u00a0158) active in a longitudinal cohort study completed a COVID\u201019 virus pandemic survey from May to September 2020 (response rate 83%). Incident sleep disturbance was measured using the restless sleep item from the Center for Epidemiological Studies\u2010Depression Scale (CES\u2010D). CES\u2010D score (minus the sleep item) captured depressive symptoms; the State\u2010Anxiety subscale of the State Trait Anxiety Inventory measured anxiety symptoms. Multivariable linear regression models examined how the development of sleep disturbance affected changes in depressive or anxiety symptoms from the most recent prepandemic survey to the pandemic survey, controlling for covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of sleep disturbance during the pandemic was 22.3%, with incident sleep disturbance in 10% and 13.5% of survivors and controls, respectively. Depressive and anxiety symptoms significantly increased during the pandemic among women with incident sleep disturbance (vs. no disturbance) (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a08.16,<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01 and<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a06.14,<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01, respectively), but there were no survivor\u2010control differences in the effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Development of sleep disturbances during the COVID\u201019 virus pandemic may negatively affect older women's mental health, but breast cancer survivors diagnosed with the nonmetastatic disease had similar experiences as women without cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4682","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T09:47:59Z","timestamp":1647942479000},"page":"3352-3363","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Associations between longitudinal changes in sleep disturbance and depressive and anxiety symptoms during the<scp>COVID<\/scp>\u201019 virus pandemic among older women with and without breast cancer in the thinking and living with breast cancer study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3205-2078","authenticated-orcid":false,"given":"Traci N.","family":"Bethea","sequence":"first","affiliation":[{"name":"Office of Minority Health and Health Disparities Research Georgetown Lombardi Comprehensive Cancer Center Washington District of Columbia USA"},{"name":"Cancer Prevention and Control Program Georgetown Lombardi Comprehensive Cancer Center Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanting","family":"Zhai","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program Georgetown Lombardi Comprehensive Cancer Center Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingtao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program Georgetown Lombardi Comprehensive Cancer Center Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim A.","family":"Ahles","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center New York New York City USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaeil","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Bioinformatics, and Biomathematics Georgetown University Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Center for the Study of Aging and Human Development Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asma A.","family":"Dilawari","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program Georgetown Lombardi Comprehensive Cancer Center Washington District of Columbia USA"},{"name":"Medstar Washington Hospital Center Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deena M. 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