Insomnia prevalent among cancer patients who receive chemotherapy

A study of 823 cancer patients showed they experienced sleep troubles at nearly three times the rate of the general population. The problem was more prevalent in younger patients and those with lung and breast cancers, according to the paper published online in the Journal of Clinical Oncology.

"These numbers are very high and something we can't ignore," said Oxana Palesh, Ph.D., M.P.H., research assistant professor of Radiation Oncology at the Medical Center's James P. Wilmot Cancer Center and lead author of the paper. "The good news is that insomnia is a very treatable problem that can be addressed quickly so it doesn't compound other symptoms."

Palesh reviewed data on patients who received chemotherapy between 1997 and 1999 at private practice medical oncology groups who were part of the National Cancer Institute's Community Clinical Oncology Program (CCOP.)

Patients answered questionnaires after their first two chemotherapy treatments. Responses to sleep-related questions showed that 37 percent of participants suffered from insomnia symptoms and another 43 percent had insomnia syndrome, as categorized by the Hamilton Depression Inventory, a widely used measure for symptoms of depression. These patients had difficulty falling asleep and staying asleep at least three days per week.

The challenge is that once people experience sleep problems and related fatigue, they begin taking naps and going to bed earlier, which perpetuates the problem and is counter-productive to getting restorative sleep at night, Palesh said.

Sleep problems are generally combined with patients complaints of fatigue and depression however, it has not been studied to determine the causes and impact on patients' quality of life.

Authors of the National Cancer Institute-funded study recognize many factors can cause sleep difficulties, such as depression and anxiety, but note the duration of treatment and extended sleep disruptions can contribute to other health problems.

Others who contributed to the study include Gary Morrow, Ph.D., M.S., Joseph Roscoe, Ph.D., Karen Mustian, Ph.D., M.P.H., Charles Heckler, Ph.D., and Michelle Janelsins, Ph.D., of Rochester's CCOP, along with Thomas Roth, Ph.D., of Henry Ford Hospital, Josee Savard, Ph.D., of Universite Laval, and Sonia Ancoli-Israel, Ph.D., of University of California-San Diego, and Jason Purnell, Ph.D., M.P.H., of Washington University.