insomnia common in patients (after) treated with chemotherapy

[Lani]

Insomnia prevalent among cancer patients who receive chemotherapy

University of Rochester study shows impact of care lingers for months

Three quarters of cancer patients and survivors treated with chemotherapy suffer insomnia or sleep disorders that often become chronic conditions, hindering patients' ability to fully recover, according to scientists at the University of Rochester Medical Center.

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.

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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.

[Laurel]

It is not surprising that breast cancer patients have difficulty sleeping during treatment due to the steroids and the estrogen drop. Explains why younger patients have more difficulty as their bodies are accustomed to a nice estrogen level that is knocked to the floor by chemo.

Later, many BC survivors are on Tamoxifen or an A.I. which are both known to cause insomnia, again due to their estrogen suppression. I have added Melatonin 20mg nightly to help with my insomnia with good results.

[Margerie]

I blamed my insomnia on the steroids during chemo. Then I blamed the herceptin. Now I am only on Arimidex and I still have it. I am do not have anxiety or depression. I have never had insomnia in my life prior to bc.

Laurel, I also take 20mg of melatonin and I throw in some Benadryl. I have excellent "sleep hygiene" (no caffeine, no tv in bed, no naps, exercise every day, etc.) but would not be able to sleep a wink without the melatonin.

So I am very glad they are addressing this issue. I don't have any other forced menopause symptoms, but insomnia stinks.

[Laurel]

Margerie,

Have you tried the dual release melatonin? I haven't because I cannot find it in a high enough dosage, but it is structured to release some initially and then later so that you sleep through the night. Lately, I have been sleeping better since exercising. Additionally, I sleep much better since switching to an A.I. from Tamoxifen.

Prior to Ca I did not think much about sleep, but now I find my brain works so much better if I have a good night's rest. My memory is mush without sleep now.

[suzan w]

I have suffered from insomnia my entire life. Tried all sorts of everything. Basically, nothing really worked except strong prescription drugs which knocked me out and left me zonked. I think it has gotten worse since breast cancer, but I have trained myself to stay in bed and let my body rest while my mind has a life of its own!