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 Up to 10 percent of adults in the developed world suffer from
chronic insomnia, and cancer patients are particularly prone to it,
researchers note in Sleep Medicine. Even though sleep disorders have
been tied to worse outcomes for cancer patients, research to date on
hasn't offered a clear picture of what circumstances might make
sleep problems more likely in people being treated for tumors.
For the current study, researchers examined data on 405 cancer
patients in Germany who were 59 years old on average and completed
two assessments of insomnia severity: once when they joined the
study and again twelve months later.
The most common malignancies were breast cancer, tumors of the
prostate or testicles, and colorectal cancer.
Most patients - 83 percent - were being treated for a first-time
cancer. The rest of them had a relapses or secondary tumors in a
different location than the original cancer.
At the start of the study, 49 percent of the patients had insomnia
symptoms, and 13 percent had severe enough sleep problems to meet
the clinical definition of insomnia, the study found.
After a year, 64 percent of the patients who started out with
insomnia were still suffering from symptoms.
"This matters for patients because they may assume that their
insomnia will disappear over time, as their cancer treatment
concludes or their mood improves," said Eric Zhou of the Dana-Farber
Cancer Institute in Boston.
"Unfortunately, this is often not the case," Zhou, who wasn't
involved in the study, said by email.
By the end of the year-long study, 53 percent of women and 39
percent of men had insomnia symptoms.
For women, the only factor that appeared to influence whether they
had insomnia at the end of the study is whether they had it at the
start.
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With men, however, having depression or using psychiatric
medications at the start of the study was associated with a greater
risk of insomnia by the end.
Among both women and men, levels of distress, depression and anxiety
increased over the year.
The study wasn't a controlled experiment designed to prove whether
or how cancer might cause insomnia or if sleep problems might impact
outcomes for people with cancer.
Another limitation is that study participants may not have
accurately recalled and reported on any symptoms, lead author
Katharina Schieber of Friedrich-Alexander University
Erlangen-Nurnberg and colleagues write. Schieber didn't respond to
requests for comment.
Still, the results offer fresh evidence that cancer-related insomnia
won't go away on its own, said Sheila Garland of Memorial
University, St. John's, Newfoundland and Labrador in Canada.
"Insomnia may be more prevalent in cancer for a few reasons,"
Garland, who wasn't involved in the study, said by email.
"First, the psychological effects of a cancer diagnosis and the
impact of treatments are enough on their own to lead to problems
sleeping," Garland said. "But other behaviors may either make sleep
worse or make it more likely that a short-term or temporary sleep
problem becomes a chronic and long-standing disorder known as
insomnia."
Making matters worse, cancer patients who worry about insomnia
compromising their cancer outcomes are apt to develop even worse and
more frequent insomnia, Garland said.
"The best advice is to seek help early instead of trying to fix it
on your own," Garland advised.
SOURCE: http://bit.ly/2IfPbII Sleep Medicine, online March 11, 2019.
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