Insomnia, sleep problems common in cancer patients

NEW YORK - More than half of cancer patients may suffer insomnia during treatment - and for some, sleep problems can persist for months afterward, according to a study.

Close to 1,000 patients having surgery for cancer were asked whether they had trouble falling asleep at night or staying asleep, by researchers led by Josee Savard of the Laval University Cancer Research Centre in Quebec.

"Insomnia is a frequent and enduring problem in patients with cancer, particularly at the syndrome level," Savard wrote in the Journal of Clinical Oncology, referring to insomnia syndrome - persistent symptoms such as requiring more than half an hour to fall asleep at least three nights a week.

"Early intervention strategies, such as cognitive-behavioral therapy, could prevent the problem from becoming more severe and chronic."

Savard and her colleagues followed up with the same patients to see if their sleep and sleep symptoms changed over the months after treatment.

The patients were between 23 and 79 years old, and most had early-stage cancers.

At the time of treatment, 59 percent of patients reported symptoms of insomnia, and about half of those were severe enough to qualify as insomnia syndrome. That rate was three times higher than in the general population.

A year and a half later, 38 percent of the participants reported insomnia symptoms.

While patients were generally less likely to report insomnia as time went on, one in seven developed symptoms in the first months after surgery.

"Sleep, including insomnia symptoms, are a really big problem for cancer patients," said Carol Enderlin, who studies sleep in breast cancer patients at the University of Arkansas for Medical Sciences in Little Rock and was not involved in the study.

The message for patients is "to be aware of sleep and the importance of sleep, to report changes in sleep to your healthcare provider before they become severe (and) to not be afraid to bring them up."

Another study published with the first found that close to two-thirds of recently treated breast cancer patients suffered from fatigue and poor sleep quality.

It's only in recent years that sleep has been recognized as a problem for cancer patients, said Julienne Bower, of the University of California, Los Angeles, who led the second study.

"There was a shift in attention a decade ago as cancer survivors were living longer," Bower said.

"Oncologists were beginning to notice that they actually were having these persistent side effects and problems, and fatigue has probably been the most common."

Her research team has been testing the effectiveness of yoga as a treatment for fatigue and tai chi for insomnia. Cognitive behavior therapy, which has helped other insomniacs, may also work.

"When people are faced with stress, when they are faced with challenges, they do much better on a good night's sleep," said Enderlin.

"It's very important, never more so than with cancer patients."