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Cancer and Cancer Treatment: Can it Affect Sleep?

Posted Aug 24 2008 1:49pm
ANNOUNCER: There can be lots of reasons why people have troubled sleep. We know every day worries can disturb our nights, but when cancer is in the picture worries seem insurmountable.

JOSÉE SAVARD, PhD: First, they may worry about what would be the consequences of the diagnosis, will they be treated, what kind of treatments they will receive, what will be the side effects. And then, when the treatments are over, then they tend to worry about the future.

ANNOUNCER: There is a lot on the minds of people facing a diagnosis of cancer, which helps explain why 45 percent of cancer patients sleep poorly.

While good sleep keeps a well person functioning on all cylinders, it's particularly important for anyone using their emotional and physical energy to fight cancer.

SONIA ANCOLI-ISRAEL, PhD: During sleep, our body tries to heal itself. That's certainly one theory about the function of sleep. And so the more rested one can be, the better one can deal both with physical problems and with just your day-to-day life.

ANNOUNCER: It's also well known that cancer treatments are tough. There are often side effects from cancer treatments and they too can contribute to sleep loss.

JOSÉE SAVARD, PhD: Radiation therapy can lead to fatigue and people who are fatigued tend to spend too much time in their bed, so they tend to develop bad sleep habits that may precipitate insomnia problems. Hormones can bring hot flashes during the night, which may interfere with sleep.

Chemotherapy can also bring hot flashes, but it can also, as we know, bring nausea; people use antiemetic medications for that that can also precipitate sleep difficulties.

Pain is an important contributing factor, particularly in the context of advanced cancer. Pain can awake patients during the night, and also more pain is associated with increased sleep difficulties.

SONIA ANCOLI-ISRAEL, PhD: When patients have to go through their treatment during the day, it might be harder for them to tolerate some of the side effects if they're particularly sleep-deprived or particularly sleepy.

ANNOUNCER: Some cancers are bigger sleep stealers than others.

JOSÉE SAVARD, PhD: Breast cancer patients are particularly vulnerable to sleep difficulties. Lung cancer patients are also likely to present sleep difficulties. Some types of cancer and some types of cancer treatment can bring intestinal problems and also urinary problems that may interfere with sleep.

ANNOUNCER: Whatever the reasons, quality sleep can be elusive. And it can stay that way.

JOSÉE SAVARD, PhD: Our data suggests that most of the cancer patients with insomnia will develop chronic insomnia, which is having sleep difficulties for more than six months. So it is very important to offer them an appropriate intervention.

ANNOUNCER: Cancer patients tire easily. A nap may be tempting, but experts advise that poorly-timed daytime napping may impact nighttime sleep.

JOSÉE SAVARD, PhD: For cancer patients who feel fatigued, we suggest them to day-nap early, early on during the day. So ideally before three in the afternoon.

ANNOUNCER: There are good bedtime habits that sleep experts encourage for all poor sleepers, and that includes cancer patients.

JOSÉE SAVARD, PhD: Go to bed only when you feel sleepy, get out of bed after fifteen or twenty minutes if you are awake. Another goal of the behavioral strategies is to re-associate the bed with sleeping. So they are instructed not to do other things in their bed than sleeping and also having sexual activities.

ANNOUNCER: Exercise might be the last thing on a cancer patient's mind, yet it could actually promote a more restful night.

SONIA ANCOLI-ISRAEL, PhD: Whether it's just taking a walk around the block or even just trying to get up out of their chair and walk around the house a little bit, that would help them sleep better at night.

ANNOUNCER: But sometimes no matter how hard you try, you just can't sleep, or sleep fitfully, waking up tired. If the problem persists, it's time to let your doctor know.

Luckily there are different sleep aids he can prescribe to help out.

SONIA ANCOLI-ISRAEL, PhD: The main sleeping pills that are on the market fall into two classes. There are the benzodiazepines and what have now been called the nonbenzodiazepine.

Most of the sleeping pills that fall into the benzodiazepine category are much longer acting. Some of them are shorter acting, but they have more side effects and so most physicians these days prescribe the nonbenzodiazepines.

ANNOUNCER: Cancer patients often have a long road ahead of them. And while doctors can help heal the physical side of cancer there's a less scientific factor that can be equally important.

SONIA ANCOLI-ISRAEL, PhD: Emotional support in general is very important for a patient with cancer. If they don't have a partner living with them that can give them that support, they don't have friends that can give them that support, then there are lots of groups that they could find out about. But the more emotional and psychological support they have, the better they will be able to deal with their cancer and the better they're able to deal with the cancer, the more likely it is they will sleep better at night as well.

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