Sleep disturbances in cancer patients: Underrecognized and undertreated

open access

"Depending on the methods used and populations studied, at least 30% and perhaps more than half of patients with cancer have insomnia (TABLE 1).^3,4,8–14 It is one of the most commonly reported complaints in this group,^15–17 and it occurs before, during, and after treatment of cancer."

Key points

Sleep disturbances, primarily insomnia, profoundly affect all aspects of quality of life.

Insomnia can be caused or worsened by a number of other conditions, such as pain, fatigue, depression, and anxiety, and these in turn can be worsened by insomnia. 

Cognitive-behavioral therapy is the treatment of choice for chronic insomnia. Underlying problems should be addressed.

Drugs are often prescribed to help cancer patients sleep but should be used with caution, as there is limited information from clinical trials in this population. 

~~~~~~~~~~~~~

Many cancer patients don’t sleep well, for a variety of reasons. It is an important problem: not only does poor sleep worsen quality of life, it may affect prognosis. Moreover, treatment is available.

Yet many physicians caring for cancer patients do not ask about sleep problems, underestimating their impact or focusing on more urgent problems. Also, patients may not want to bring up the topic because they consider poor sleep to be unavoidable and untreatable and because they fear that reporting it may shift the focus of their treatment from trying to cure the cancer to easing its symptoms.

This practical review will help health care professionals avoid the common barriers to diagnosis and treatment of poor sleep in cancer patients. Because there are few data on other sleep disorders such as sleep apnea and restless leg syndrome, we will focus on the most common one in cancer patients—insomnia—and its effects on other symptoms and quality of life....