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Sleep dysfunction in patients with cancer

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Opinion statement

Sleep complaints are common in cancer patients. Insomnia is particularly a concern in this population. Although pharmacotherapy is the most prescribed treatment for sleep disturbances, there is evidence that cognitive-behavioral therapy (CBT) is an effective treatment for insomnia in all patients, including those with cancer. CBT for insomnia is a flexible treatment, tailored to the needs of a specific patient, and focusing on behavioral and psychologic skills that foster better sleep and lower anxiety. Many cancer patients with insomnia may be hesitant to use drugs for their sleep treatment because they are already overwhelmed by the chemical and pharmacologic treatments they are prescribed for the cancer; thus, CBT may become the treatment of choice for insomnia in these patients.

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References and Recommended Reading

  1. Ancoli-Israel S, Moore P, Jones V: The relationship between fatigue and sleep in cancer patients: a review. Eur J Cancer Care (Engl) 2001, 10:245–255.

    Article  CAS  Google Scholar 

  2. Savard J, Morin CM: Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 2001, 19:895–908.

    PubMed  CAS  Google Scholar 

  3. Fiorentino L, Ancoli-Israel S: Insomnia and its treatment in women with breast cancer. Sleep Med Rev 2006, 10:419–429.

    Article  PubMed  Google Scholar 

  4. Nesse W, Hoekema A, Stegenga B, et al.: Prevalence of obstructive sleep apnoea following head and neck cancer treatment: a cross-sectional study. Oral Oncol 2006, 42:108–114.

    Article  PubMed  Google Scholar 

  5. Berger AM, Parker KP, Young-McCaughan S, et al.: Sleep wake disturbances in people with cancer and their caregivers: state of the science. Oncol Nurs Forum 2005, 32:E98–E126.

    Article  PubMed  Google Scholar 

  6. Cimprich B: Pretreatment symptom distress in women newly diagnosed with breast cancer. Cancer Nurs 1999, 22:185–194.

    Article  PubMed  CAS  Google Scholar 

  7. Engstrom CA, Strohl RA, Rose L, et al.: Sleep alterations in cancer patients. Cancer Nurs 1999, 22:143–148.

    Article  PubMed  CAS  Google Scholar 

  8. Anderson KO, Getto CJ, Mendoza TR, et al.: Fatigue and sleep disturbance in patients with cancer, patients with clinical depression, and community-dwelling adults. J Pain Symptom Manage 2003, 25:307–318.

    Article  PubMed  Google Scholar 

  9. Sela RA, Watanabe S, Nekolaichuk CL: Sleep disturbances in palliative cancer patients attending a pain and symptom control clinic. Palliat Support Care 2005, 3:23–31.

    Article  PubMed  Google Scholar 

  10. Davidson JR, MacLean AW, Brundage MD, Schulze K: Sleep disturbance in cancer patients. Soc Sci Med 2002, 54:1309–1321.

    Article  PubMed  Google Scholar 

  11. Holland JC, Plumb M: A comparative study of depressive symptoms in patients with advanced cancer. Proc Am Assoc Cancer Res 1977, 18:201.

    Google Scholar 

  12. Savard J, Simard S, Blanchet J, et al.: Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep 2001, 24:583–590.

    PubMed  CAS  Google Scholar 

  13. Silberfarb PM, Hauri PJ, Oxman TE, Schnurr PP: Assessment of sleep in patients with lung cancer and breast cancer. J Clin Oncol 1993, 11:997–1004.

    PubMed  CAS  Google Scholar 

  14. Ancoli-Israel S: Sleep and fatigue in cancer patients. In Principles and Practice of Sleep Medicine. Edited by Kryger MH, Roth T, Dement WC. Philadelphia: WB Saunders; 2005:1218–1224.

    Google Scholar 

  15. Fiorentino L, Mason W, Parker B, et al.: Sleep disruption in breast cancer patients post-chemotherapy. Sleep 2005, 28:A294.

    Google Scholar 

  16. Savard J, Simard S, Ivers H, Morin CM: Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, part I: sleep and psychological effects. J Clin Oncol 2005, 23:6083–6096.

    Article  PubMed  Google Scholar 

  17. Savard J, Davidson JR, Ivers H, et al.: The association between nocturnal hot flashes and sleep in breast cancer survivors. J Pain Symptom Manage 2004, 27:513–522.

    Article  PubMed  Google Scholar 

  18. Ancoli-Israel S, Cole R, Alessi CA, et al.: The role of actigraphy in the study of sleep and circadian rhythms. Sleep 2003, 26:342–392.

    PubMed  Google Scholar 

  19. Miaskowski C, Lee KA: Pain, fatigue and sleep disturbances in oncology outpatients receiving radiation therapy for bone metastasis: a pilot study. J Pain Symptom Manage 1999, 17:320–332.

    Article  PubMed  CAS  Google Scholar 

  20. Payne JK, Piper B, Rabinowitz I, Zimmerman B: Biomarkers, fatigue, sleep, and depressive symptoms in women with breast cancer: a pilot study. Oncol Nurs Forum 2006, 33:775–783.

    Article  PubMed  Google Scholar 

  21. Ancoli-Israel S, Liu L, Marler M, et al.: Fatigue, sleep and circadian rhythms prior to chemotherapy for breast cancer. Support Care Cancer 2006, 14:201–209.

    Article  PubMed  Google Scholar 

  22. Liu L, Parker B, Dimsdale J, et al.: Pre-treatment subjective sleep quality predicts fatigue, mood, and quality of life in breast cancer patients during chemotherapy. Sleep 2006, 29(Suppl):A309.

    Google Scholar 

  23. Palesh OG, Collie K, Batiuchok D, et al.: A longitudinal study of depression, pain, and stress as predictors of sleep disturbance among women with metastatic breast cancer. Biol Psychol 2007, 75:37–44.

    Article  PubMed  Google Scholar 

  24. Speilman AJ, Glovinsky PB: Case studies in insomnia. In The Varied Nature of Insomnia. Edited by Hauri PJ. New York: Plenum Press; 1991:1–15.

    Google Scholar 

  25. Hu D, Silberfarb PM: Management of sleep problems in cancer patients. Oncology 1991, 5:23–27.

    PubMed  CAS  Google Scholar 

  26. Lewin DS, Dahl RE: Importance of sleep in the management of pediatric pain. J Dev Behav Pediatr 1999, 20:244–252.

    Article  PubMed  CAS  Google Scholar 

  27. Dimsdale JE, Norman D, DeJardin D, Wallace MS: The effect of opioids on sleep architecture. J Clin Sleep Med 2007, 3:33–36.

    PubMed  Google Scholar 

  28. Lee K, Cho M, Miaskowski C, Dodd M: Impaired sleep and rhythms in persons with cancer. Sleep Med Rev 2004, 8:199–212.

    Article  PubMed  Google Scholar 

  29. Moser M, Schaumberger K, Schernhammer E, Stevens RG: Cancer and rhythm. Cancer Causes Control 2006, 17:483–487.

    Article  PubMed  Google Scholar 

  30. Mormont MC, Waterhouse J, Bleuzen P, et al.: Marked 24-h rest/activity rhythms are associated with better quality of life, better response and longer survival in patients with metastatic colorectal cancer and good performance status. Clin Cancer Res 2000, 6:3038–3045.

    PubMed  CAS  Google Scholar 

  31. Liu L, Marler M, Parker BA, et al.: The relationship between fatigue and light exposure during chemotherapy. Support Care Cancer 2005, 13:1010–1017.

    Article  PubMed  Google Scholar 

  32. Levi F: Chronotherapeutics: the relevance of timing in cancer therapy. Cancer Causes Control 2006, 17:611–621.

    Article  PubMed  Google Scholar 

  33. Wood PA, Hrushesky WJM: Circadian rhythms and cancer chemotherapy. Crit Rev Eukaryot Gene Expr 1996, 6:299–343.

    PubMed  CAS  Google Scholar 

  34. Rich T, Innominato PF, Boerner J, et al.: Elevated serum cytokines correlated with altered behavior, serum cortisol rhythm, and dampened 24-hour rest-activity patterns in patients with metastatic colorectal cancer. Clin Cancer Res 2005, 11:1757–1764.

    Article  PubMed  CAS  Google Scholar 

  35. Lee BN, Dantzer R, Langley KE, et al.: A cytokine-based neuroimmunologic mechanism of cancer-related symptoms. Neuroimmunomodulation 2004, 11:279–292.

    Article  PubMed  CAS  Google Scholar 

  36. Vgontzas AN, Pejovic S, Zoumakis E, et al.: Daytime napping after a night of sleep loss decreases sleepiness, improves performance, and causes beneficial changes in cortisol and interleukin-6 secretion. Am J Physiol Endocrinol Metab 2006, 292:E253–E261.

    Article  PubMed  CAS  Google Scholar 

  37. Mills PJ, Parker BA, Dimsdale JE, et al.: The relationship between fatigue, quality of life and inflammation during anthracycline-based chemotherapy in breast cancer. Biol Psychol 2005, 69:85–96.

    Article  PubMed  Google Scholar 

  38. Mills PJ, Parker BA, Jones V, et al.: The effects of standard anthracycline-based chemotherapy on soluble ICAM-1 and vascular endothelial growth factor levels in breast cancer. Clin Cancer Res 2004, 10:4998–5003.

    Article  PubMed  CAS  Google Scholar 

  39. Savard J, Simard S, Ivers H, Morin CM: Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, part II: immunologic effects. J Clin Oncol 2005, 23:6097–6106.

    Article  PubMed  Google Scholar 

  40. Kelley KW, Bluthe RM, Dantzer R, et al.: Cytokine-induced sickness behavior. Brain Behav Immun 2003, 17:S112–S118.

    Article  PubMed  CAS  Google Scholar 

  41. Derogatis LR, Feldstein M, Morrow G, et al.: A survey of psychotropic drug prescriptions in an oncology population. Cancer 1979, 44:1919–1929.

    Article  PubMed  CAS  Google Scholar 

  42. Stiefel FC, Kornblith AB, Holland JC: Changes in the prescription patterns of psychotropic drugs over a 10-year period. Cancer 1990, 65:1048–1053.

    Article  PubMed  CAS  Google Scholar 

  43. National Institutes of Health State of the Science Conference Statement on Manifestations and Management of Chronic Insomnia in Adults, June 13–15, 2005. Sleep 2005, 28:1049–1058.

  44. Bastien CH, Morin CM, Ouellet MC, et al.: Cognitive-behavioral therapy for insomnia: comparison of individual therapy, group therapy, and telephone consultations. J Consult Clin Psychol 2004, 72:653–659.

    Article  PubMed  Google Scholar 

  45. Quesnel C, Savard J, Simard S, et al.: Efficacy of cognitive-behavioral therapy for insomnia in women treated for nonmetastatic breast cancer. J Consult Clin Psychol 2003, 71:189–200.

    Article  PubMed  Google Scholar 

  46. Morin CM, Colecchi C, Stone J, et al.: Behavioral and pharmacological therapies for late life insomnia. JAMA 1999, 281:991–999.

    Article  PubMed  CAS  Google Scholar 

  47. Theobald DE: Cancer pain, fatigue, distress, and insomnia in cancer patients. Clin Cornerstone 2004, 6:S15–S21.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry 0603, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA

    Sonia Ancoli-Israel PhD

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  1. Lavinia Fiorentino MS
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  2. Sonia Ancoli-Israel PhD
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Correspondence to Sonia Ancoli-Israel PhD.

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Fiorentino, L., Ancoli-Israel, S. Sleep dysfunction in patients with cancer. Curr Treat Options Neurol 9, 337–346 (2007). https://doi.org/10.1007/s11940-007-0019-0

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