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Insomnia is Common, Likely Under-Diagnosed Among People with Cancer Undergoing Chemotherapy

Written by: David Castillo on November 25th, 2009

Insomnia is Common, Likely Under-Diagnosed Among People with Cancer Undergoing Chemotherapy | read this item

(Media-Newswire.com) – Researchers have found that 43 percent of patients undergoing chemotherapy for cancer in a clinical trial met the clinical criteria for insomnia syndrome and an additional 37 percent had insomnia symptoms, suggesting that the majority of patients ( 80 percent ) suffer from sleep difficulties. This rate is approximately two to three times higher than that seen in the general population.

Insomnia syndrome is defined as difficulty sleeping three or more times per week for at least a month, and can cause significant distress or impairment in daytime functioning. Prior studies have identified increases in sleep disturbances among people with cancer; this is the first to show an elevated risk of insomnia syndrome in people undergoing active cancer treatment with chemotherapy.

“Our research shows that insomnia is very common among patients undergoing cancer treatment and is likely under-diagnosed. The good news for people with cancer is that there are many effective treatment options that can help,” said Oxana Palesh, PhD, MPH, lead author and research assistant professor in the Departments of Radiation Oncology and Psychiatry at the University of Rochester Medical Center in New York. “Patients who have difficulties sleeping should talk to their doctors, who can provide helpful tools and treatments, like medication or referrals to a sleep clinic.” Dr. Palesh added that cognitive behavioral therapy for insomnia, exercise, and yoga are all beneficial for the treatment of insomnia, when feasible.

To examine the prevalence of insomnia among a large group of patients undergoing cancer treatment Dr. Palesh and colleagues performed a subset analysis of data from a prospective trial of 823 patients undergoing chemotherapy for a range of cancer types enrolled between 1997 and 1999. During the first two cycles of chemotherapy, patients were asked to report any sleep difficulties. Researchers found that 43 percent of patients experienced insomnia syndrome and an additional 36.6 percent reported insomnia symptoms during cycle 1 of chemotherapy; during cycle 2, 35.2 percent experienced insomnia syndrome and an additional 33.1 percent reported insomnia symptoms. By comparison, the prevalence of insomnia syndrome in the general population ranges from 16 to 21 percent.

The prevalence of insomnia syndrome was highest among patients with lung cancer ( 50.8 percent ), and it was most prevalent among patients under age 58 ( the median age of the patients ): 85.6 percent had insomnia, versus 75.5 percent among those age 58 and older. Patients with insomnia syndrome reported more depression ( 32.3 percent ) and fatigue ( 45.5 percent ) than those who reported sleeping well ( 10.4 percent and 30.8 percent, respectively ).

The authors speculated that the side effects of cancer treatments as well as the stress and anxiety of a cancer diagnosis may contribute to insomnia, but this study did not examine the reasons for insomnia. They also added that some chemotherapy drugs used today are different than those received by patients in this study and may therefore influence sleep patterns differently among patients today.

ASCO Perspective

Sarita Dubey, MD, Member of ASCO’s Cancer Communications Committee; Head, Neck and Lung Cancer Specialist at the University of California, San Francisco Medical Center

“Insomnia has real and potentially serious implications for patients’ quality of life. This study highlights the fact that it’s very common among patients undergoing active cancer treatment and is likely not adequately recognized in clinical practice. It’s clear this is an area where more awareness is needed so patients can get the additional help they need. ”

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