Insomnia a Big Problem for Cancer Patients

Torrance, CA - August 8, 2001

The Breast Cancer Care & Research Fund has posted a recent article involving sleeplessness and cancer. "Insomnia - A Common but Neglected Problem in Cancer Patients" is a lead story this month at their website. The story is a review of an article published in the peer-reviewed Journal of Clinical Oncology in February 2001, and also includes a commentary by Anne Webster, Ph.D., Director of the Mind/Body Cancer Program at Beth Israel Deaconess Medical Center in Boston, Massachusetts.

In the journal article, Canadian researchers Josee Savard and insomnia expert Charles M. Morin looked into the issue of insomnia among cancer patients. After surveying the existing scientific literature (some 122 papers on insomnia and cancer), they concluded that insomnia is a commonly neglected problem among the cancer population, one that merits more research and effective treatments for the patients affected by insomnia.

The authors conclude that insomnia treatments that work for healthy individuals also seem to be effective in cancer patients, but caution against long-term use of hypnotic medications. According to the authors, "it is argued that psychologic interventions (e.g. stimulus control, sleep restriction, cognitive therapy) are the treatment of choice for sleep disturbances in the context of cancer, especially when it has reached a chronic course." They point out, though, that the efficacy of these treatments in cancer patients has not yet been verified.

The Breastlink review of the article points out that insomnia is well known among cancer patients, affecting between 30 and 50 percent of patients. However, the insomnia is generally thought to be a temporary problem related to the cancer diagnosis or treatment. High rates of insomnia symptoms were reported even two to five years after treatment, ranging from 23 to 44 percent. In a new study by the Canadian researchers, one-third of the insomnia patients reported that their insomnia symptoms began after their breast cancer diagnosis.

"Treatment of insomnia in cancer patients" says Breastlink, "involves addressing both physical and psychological factors." The use of medications such as antianxiety drugs and antidepressants to treat insomnia is common, but there are risks involved with some of these medications. In the normal population, non-drug therapies such as cognitive-behavioral techniques have been effective in 70 to 80 percent of patients.

"Insomnia is the number one symptom in my cancer group," says Anne Webster, PhD, Director of the Mind/Body Cancer Program at Beth Israel Deaconess Medical Center in Boston. "I don't think doctors ask about it, and patients are just too overwhelmed with other things, such as chemotherapy, nausea, and pain to even bring up sleep."

Dr. Webster, who directs a 10-week, drug-free program that teaches cancer patients behavioral and cognitive techniques for overcoming insomnia and managing stress, feels that treatment for insomnia should be a part of routine treatment for cancer patients.

"At the very least", says Webster, "physicians should ask patients, 'Are you having trouble sleeping?' If the patient says she is, then ask whether she wants sleep medication or whether she would like to be referred to a mind-body clinic where she could learn some relaxation techniques and do some cognitive therapy, so she wouldn't have to take drugs."

For more information about cancer and sleep disorders, see "Sleep Disorders in Cancer Patients", from the National Cancer Institute.

For more information about breast cancer contact The Breast Cancer Care & Research Fund, which is a publicly supported non-profit 501(C)3 organization.

The Breast Cancer Care & Research Fund
23430 Hawthorne Blvd., Suite 350
Torrance, CA, 90505
Phone: 310.791.6295.