Sleep Disorders and Cancer

• Introduction
• Overview of Sleep Disorders
• Risk Factors for Sleep Disorders
• Diagnosis of Sleep Disorders
• Treatment of Sleep Disorders
• To Learn More
• About PDQ

Introduction

This patient summary on sleep disorders is adapted from a summary written for health professionals by cancer experts. This and other credible information about cancer treatment, screening, prevention, supportive care, and ongoing clinical trials is available from the National Cancer Institute. Sleep disorders may be caused by tumor growth, cancer therapy, or other factors. This brief summary describes sleep disorders, their causes and treatment.

Overview of Sleep Disorders

Sleep disorders occur in some people with cancer and may be caused by physical illness, pain, treatment drugs, being in the hospital, and emotional stress. Sleep has two phases: rapid eye movement (REM) and non-REM (NREM). REM sleep, also known as "dream sleep," is the phase of sleep in which the brain is active. NREM is the quiet or restful phase of sleep. The stages of sleep occur in a repeated pattern of NREM followed by REM. Each sleep cycle lasts about 90 minutes and is repeated 4 to 6 times during a 7- to 8-hour sleep period. The four major categories of sleep disorders that interfere with normal sleep patterns include: the inability to fall asleep and stay asleep (insomnia); disorders of the sleep-wake cycle; disorders associated with sleep stages, or partial waking (parasomnia); and excessive sleepiness.

Risk Factors for Sleep Disorders

The sleep disorders most likely to affect patients with cancer are insomnias and disorders of the sleep-wake cycle. Effects of tumor growth and cancer treatment that may cause sleep disturbances include: anxiety, depression, pain, fever, cough, breathing problems, itching, fatigue, seizures, headaches, night sweats, hot flashes, diarrhea, constipation, nausea, and the inability to control bodily functions. Patients may have sleep interruptions due to treatment schedules, hospital routines, and roommates. Other factors affecting sleep during a hospital stay include noise, temperature, pain, anxiety, and the patient's age. Chronic sleep disturbances can cause irritability, inability to concentrate, depression, and anxiety. While in the hospital, sleep disorders may make it hard for the patient to continue with cancer therapy.

Diagnosis of Sleep Disorders

To diagnose sleep disorders in cancer patients, the doctor will get the patient's complete medical history and give a physical examination. The doctor may get information about the patient's sleep history and patterns of sleep from the patient, from observations, and from the patient's family and friends. A polysomnogram, an instrument that measures brain waves, eye movements, muscle tone, heart rate, and breathing during sleep, may also be used to diagnose sleep disorders in patients with cancer.

Treatment of Sleep Disorders

Sleep disorders that are related to cancer may be treated by eliminating the cancer and side effects of cancer treatment. To promote rest and treat sleep disorders the following may be considered:

Create an environment that decreases sleep interruptions by lowering noise; dimming or turning off lights; adjusting room temperature; keeping bedding, chairs, and pillows clean, dry, and wrinkle-free; using bedcovers for warmth; placing pillows in a supportive position, and encouraging the patient to dress in loose, soft clothing.

Encourage regular bowel and bladder habits to minimize sleep interruptions, such as no drinking before bedtime, emptying the bowel and bladder before going to bed, increasing consumption of fluids and fiber during the day, and taking medication for incontinence before bedtime.

Rest in patients with cancer may also be promoted by eating a high-protein snack 2 hours before bedtime, avoiding drinks with caffeine, exercising (which should be completed at least 2 hours before bedtime), and keeping regular sleeping hours. Drugs may also be used to help patients with cancer manage their sleep disorders.

To Learn More Call

For more information, U.S. residents may call the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Publications

The National Cancer Institute (NCI) has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

LiveHelp

The NCI's LiveHelp http://cancer.gov/livehelp/vp/vp_sq.html service, a program available on several of the Institute's Web sites, provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 5:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Organizations and Web sites

There are many other places where people can get materials and information about cancer treatment and services. Local hospitals may have information on local and regional agencies that offer information about finances, getting to and from treatment, receiving care at home, and dealing with problems associated with cancer treatment. A list of organizations and Web sites that offer information and services for cancer patients and their families is available on cancer.gov (http://cancer.gov/support_resources.html ).

For more information from the NCI, please write to this address:

National Cancer Institute
Office of Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

About PDQ

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available on cancer.gov, the NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research. PDQ available on www.cancer.gov.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, non-technical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date at the top of each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

Some patients have symptoms caused by cancer treatment or by the cancer itself. Patients who have symptoms related to cancer treatment may want to take part in a clinical trial. A clinical trial is a study to answer a scientific question, such as whether one method of treating symptoms is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During supportive care clinical trials, information is collected about new treatment methods, the risks involved, and how well they do or do not work. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard."

Listings of clinical trials are included in PDQ and are available at http://cancer.gov/search/clinical_trials 3. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Date Last Modified: 01/2002