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14 - Sleep and its disorders: clinical science

from Section 2 - Cancer Symptom Mechanisms and Models: Clinical and Basic Science

Published online by Cambridge University Press:  05 August 2011

By
Lianqi Liu  and
Sonia Ancoli-Israel
Edited by
Charles S. Cleeland ,
Michael J. Fisch  and
Adrian J. Dunn
Lianqi Liu
Affiliation:
University of California San Diego
Sonia Ancoli-Israel
Affiliation:
University of California San Diego
Charles S. Cleeland
Affiliation:
University of Texas, M. D. Anderson Cancer Center
Michael J. Fisch
Affiliation:
University of Texas, M. D. Anderson Cancer Center
Adrian J. Dunn
Affiliation:
University of Hawaii, Manoa
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Summary

Sleep disturbances are common in patients with cancer yet are often neglected. Most of the sleep studies conducted in patients with cancer have been related almost exclusively to insomnia; other kinds of sleep disturbances – for example, sleep-disordered breathing and periodic limb movement – have rarely been studied in relation to cancer. Systematic research into other sleep disorders commonly seen in the general population, such as circadian-rhythm disturbances and restless legs syndrome, is rare in patients with cancer.

To understand the relationship between sleep disorders and cancer, one must first have a general understanding of the various sleep disorders. The sleep disorders most common in patients with cancer are insomnias, sleep-related breathing disorders, sleep-related movement disorders, and circadian-rhythm sleep disorders. In this chapter we present a brief introduction of several of these relatively common sleep problems, followed by discussion of the prevalence, possible reasons, and treatment of sleep disturbance in cancer and a consideration of future research and treatment directions.

Common sleep disorders

Insomnia

Insomnia is defi ned as diffi culty with sleep initiation or maintenance that (1) occurs despite adequate time and opportunity for sleep, and (2) results in some form of daytime impairment, such as clinically significant distress, fatigue, or impairment in social, occupational, or other important areas of functioning. Insomnia can be divided into two types of complaints, depending upon the duration of the sleep difficulty.

Type
Chapter
Information
Cancer Symptom Science
Measurement, Mechanisms, and Management
 , pp. 160 - 169
Publisher: Cambridge University Press
Print publication year: 2010

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References

Ancoli-Israel, S, Moore, P, Jones, V. The relationship between fatigue and sleep in cancer patients: a review. Eur J Cancer Care (Engl) 10(4):245–255, 2001.CrossRefGoogle ScholarPubMed
Savard, J, Morin, CM. Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 19(3):895–908, 2001.CrossRefGoogle ScholarPubMed
Nesse, W, Hoekema, A, Stegenga, B, Hoeven, JH, Bont, LG, Roodenburg, JL. Prevalence of obstructive sleep apnoea following head and neck cancer treatment: a cross-sectional study. Oral Oncol 42(1):108–114, 2006.CrossRefGoogle ScholarPubMed
Savard, J, Simard, S, Blanchet, J, Ivers, H, Morin, CM. Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep 24(5):583–590, 2001.CrossRefGoogle ScholarPubMed
Ancoli-Israel, S. The impact and prevalence of chronic insomnia and other sleep disturbances associated with chronic illness. Am J Manag Care 12(8 Suppl):S221–S229, 2006.Google ScholarPubMed
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 32(6):E98–126, 2005.CrossRefGoogle ScholarPubMed
Derogatis, LR, Feldstein, M, Morrow, G, et al. A survey of psychotropic drug prescriptions in an oncology population. Cancer 44:1919–1929, 1979.3.0.CO;2-T>CrossRefGoogle Scholar
Stiefel, FC, Kornblith, AB, Holland, JC. Changes in the prescription patterns of psychotropic drugs over a 10-year period. Cancer 65:1048–1053, 1990.3.0.CO;2-N>CrossRefGoogle Scholar
Cimprich, B. Pretreatment symptom distress in women newly diagnosed with breast cancer. Cancer Nurs 22:185–194, 1999.CrossRefGoogle ScholarPubMed
Engstrom, CA, Strohl, RA, Rose, L, Lewandowski, L, Stefanek, ME. Sleep alterations in cancer patients. Cancer Nurs 22:143–148, 1999.CrossRefGoogle ScholarPubMed
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 25(4):307–318, 2003.CrossRefGoogle ScholarPubMed
Davidson, JR, MacLean, AW, Brundage, MD, Schulze, K. Sleep disturbance in cancer patients. Soc Sci Med 54(9):1309–1321, 2002.CrossRefGoogle ScholarPubMed
Holland, JC, Plumb, M. A comparative study of depressive symptoms in patients with advanced cancer. Proc Am Assoc Cancer Res 18:201, 1977.Google Scholar
Silberfarb, PM, Hauri, PJ, Oxman, TE, Schnurr, PP. Assessment of sleep in patients with lung cancer and breast cancer. J Clin Oncol 11(5):997–1004, 1993.CrossRefGoogle ScholarPubMed
Ancoli-Israel, S. Sleep and fatigue in cancer patients. In: Kryger, MH, Roth, T, Dement, WC, eds. Principles and Practice of Sleep Medicine. Philadelphia: W.B. Saunders, 2005:1218–1224.CrossRefGoogle Scholar
Savard, J, Davidson, JR, Ivers, H, et al. The association between nocturnal hot flashes and sleep in breast cancer survivors. J Pain Symptom Manage 27(6):513–522, 2004.CrossRefGoogle ScholarPubMed
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 23(25):6083–6096, 2005.CrossRefGoogle ScholarPubMed
Ancoli-Israel, S, Cole, R, Alessi, CA, Chambers, M, Moorcroft, WH, Pollak, C. The role of actigraphy in the study of sleep and circadian rhythms. Sleep 26(3):342–392, 2003.CrossRefGoogle Scholar
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 17(5):320–332, 1999.CrossRefGoogle ScholarPubMed
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 33(4):775–783, 2006.CrossRefGoogle ScholarPubMed
Ancoli-Israel, S, Liu, L, Marler, M, et al. Fatigue, sleep and circadian rhythms prior to chemotherapy for breast cancer. Support Care Cancer 14(3):201–209, 2006.CrossRefGoogle ScholarPubMed
Liu, L, Fiorentino, L, Natarajan, L, et al. Pre-treatment symptom cluster in breast cancer patients is associated with worse sleep, fatigue and depression during chemotherapy. Psychooncology: e-pub ahead of print, 2008.Google Scholar
Speilman, AJ, Glovinsky, PB. Case studies in insomnia. In: Hauri, PJ, ed. The Varied Nature of Insomnia. New York: Plenum Press, 1991:1–15.Google Scholar
Hu, D, Silberfarb, PM. Management of sleep problems in cancer patients. Oncology 5:23–27, 1991.Google ScholarPubMed
Lewin, DS, Dahl, RE. Importance of sleep in the management of pediatric pain. J Dev Behav Pediatr 20(4):244–252, 1999.CrossRefGoogle ScholarPubMed
Dimsdale, JE, Norman, D, DeJardin, D, Wallace, MS. The effect of opioids on sleep architecture. J Clin Sleep Med 3(1):33–36, 2007.Google ScholarPubMed
Lee, K, Cho, M, Miaskowski, C, Dodd, M. Impaired sleep and rhythms in persons with cancer. Sleep Med Rev 8(3):199–212, 2004.CrossRefGoogle ScholarPubMed
Moser, M, Schaumberger, K, Schernhammer, E, Stevens, RG. Cancer and rhythm. Cancer Causes Control 17(4):483–487, 2006.CrossRefGoogle ScholarPubMed
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 6:3038–3045, 2000.Google ScholarPubMed
Liu, L, Marler, M, Parker, BA, et al. The relationship between fatigue and light exposure during chemotherapy. Support Care Cancer 13(12):1010–1017, 2005.CrossRefGoogle ScholarPubMed
Mercadante, S, Girelli, D, Casuccio, A. Sleep disorders in advanced cancer patients: prevalence and factors associated. Support Care Cancer 12(5):355–359, 2004.CrossRefGoogle ScholarPubMed
Lévi, F. Chronotherapeutics: the relevance of timing in cancer therapy. Cancer Causes Control 17(4):611–621, 2006.CrossRefGoogle ScholarPubMed
Wood, PA, Hrushesky, WJM. Circadian rhythms and cancer chemotherapy. Crit Rev Eukaryot Gene Expr 6:299–343, 1996.CrossRefGoogle ScholarPubMed
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 11(5):1757–1764, 2005.CrossRefGoogle ScholarPubMed
Lee, BN, Dantzer, R, Langley, KE, et al. A cytokine-based neuroimmunologic mechanism of cancer-related symptoms. Neuroimmunomodulation 11(5):279–292, 2004.CrossRefGoogle ScholarPubMed
Kelley, KW, Bluthé, RM, Dantzer, R, et al. Cytokine-induced sickness behavior. Brain Behav Immun 17:S112–S118, 2003.CrossRefGoogle ScholarPubMed
Vena, C, Parker, K, Cunningham, M, Clark, J, McMillan, S. Sleep-wake disturbances in people with cancer part I: an overview of sleep, sleep regulation, and effects of disease and treatment. Oncol Nurs Forum 31(4):735–746, 2004.CrossRefGoogle ScholarPubMed
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 292(1):E253–E261, 2007.CrossRefGoogle ScholarPubMed
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 10(15):4998–5003, 2004.CrossRefGoogle ScholarPubMed
Mills, PJ, Parker, BA, Dimsdale, JE, Sadler, GR, Ancoli-Israel, S. The relationship between fatigue, quality of life and inflammation during anthracycline-based chemotherapy in breast cancer. Biol Psychol 69(1):85–96, 2005.CrossRefGoogle ScholarPubMed
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 23(25):6097–6106, 2005.CrossRefGoogle ScholarPubMed
Clark, J, Cunningham, M, McMillan, S, Vena, C, Parker, K. Sleep-wake disturbances in people with cancer part II: evaluating the evidence for clinical decision making. Oncol Nurs Forum 31(4):747–771, 2004.CrossRefGoogle ScholarPubMed
,National Institutes of Health. National Institutes of Health State of the Science Conference statement on manifestations and management of chronic insomnia in adults, June 13–15, 2005. Sleep 28(9):1049–1058, 2005.Google Scholar
Bastien, CH, Morin, CM, Ouellet, MC, Blais, FC, Bouchard, S. Cognitive-behavioral therapy for insomnia: comparison of individual therapy, group therapy, and telephone consultations. J Consult Clin Psychol 72(4):653–659, 2004.CrossRefGoogle ScholarPubMed
Quesnel, C, Savard, J, Simard, S, Ivers, H, Morin, CM. Efficacy of cognitive-behavioral therapy for insomnia in women treated for nonmetastatic breast cancer. J Consult Clin Psychol 71(1):189–200, 2003.CrossRefGoogle ScholarPubMed
Morin, CM, Colecchi, C, Stone, J, Sood, R, Brink, D. Behavioral and pharmacological therapies for late life insomnia. JAMA 281(11):991–999, 1999.CrossRefGoogle ScholarPubMed
Theobald, . Cancer pain, fatigue, distress, and insomnia in cancer patients. Clin Cornerstone 6(Suppl 1D):S15–S21, 2004.CrossRefGoogle ScholarPubMed
Cohrs, S, Rodenbeck, A, Guan, Z, et al. Sleep-promoting properties of quetiapine in healthy subjects. Psychopharmacology (Berl) 174(3):421–429, 2004.CrossRefGoogle ScholarPubMed

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