Obese mother, obese child: A convergent mixed methods study of intergenerational obesity in low-income households in Malaysia.

Sleep disturbance is among the most commonly reported symptoms in cancer populations and represents a major contributor to impaired quality of life (QoL). It often emerges at the time of diagnosis and persists throughout the course of the disease [, ]. Poor sleep quality (PSQ), insomnia symptoms, and nocturnal awakenings have been frequently reported even at the time of cancer diagnosis, prior to initiation of oncological treatment [, ]. Beyond its impact on QoL, sleep disturbance is associated with significant morbidity and functional impairment []. Depressive symptoms are also highly prevalent around the time of diagnosis and represent one of the most common psychological challenges during this period []. Sleep disturbance and depression frequently co‐occur and share a bidirectional relationship. Sleep problems increase the risk of developing depressive symptoms, while depression may further exacerbate sleep disturbance [, ]. Contemporary psycho‐oncology frameworks increasingly conceptualize sleep disturbance not only as a consequence of depression but also as an independent behavioral process that may contribute to the onset and maintenance of depressive symptoms []. From a clinical perspective, sleep disturbances may occur as primary disorders or as secondary manifestations of psychological or medical conditions. According to contemporary diagnostic frameworks, including DSM‐5 classifications, insomnia can present as a distinct disorder but more commonly arises in association with factors such as depression, anxiety, chronic illness, or systemic physiological stress. In cancer populations, they are often interpreted as responses to emotional distress or disease burden; however, emerging biobehavioral models suggest that sleep disturbance may also reflect interactions between psychological and biological pathways. Growing evidence indicates that sleep disturbance is associated with systemic inflammation. Studies in both general and clinical populations have demonstrated links between PSQ and elevated proinflammatory markers such as C‐reactive protein (CRP), interleukin‐6 (IL‐6), and tumor necrosis factor‐α (TNF‐α) [, ]. Meta‐analyses further suggest that sleep disturbance is related to inflammatory activation independent of sleep duration []. In cancer, inflammation is a central biological process and has been implicated in behavioral comorbidities including fatigue, depression, and sleep disturbance [, ].