Insomnia and Cancer
Posted 8/20/2011
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This short report from ASCO confirms what we all know: the time of diagnosis and treatment of cancer is not the time we do our best sleeping. Whether this is due to stress, anxiety, chemicals and drugs, who knows? I do know that you have to sleep and everything is much worse if you don't. Many women take a sleeping medication (usually a light one) during these months and come off it without undue difficulties later.
©American Society of Clinical Oncology
Natural Course of Insomnia Comorbid With Cancer: An 18-Month Longitudinal Study
Josée Savard!, Hans Ivers, Julie Villa, Aude Caplette-Gingras and Charles M. Morin
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Author Affiliations
Corresponding author: Josée Savard, PhD, Laval University Cancer Research Center, 11 Côte du Palais, Québec, Québec, Canada G1R 2J6; e-mail: josee.savard@psy.ulaval.ca.
Abstract
Purpose This study aimed to assess the prevalence and natural course (incidence, persistence, remission, and relapse) of insomnia comorbid with cancer during an 18- month period.
Patients and Methods All patients scheduled to receive a curative surgery for a first diagnosis of nonmetastatic cancer were approached on the day of their preoperative visit to participate in the study. A total of 962 patients with cancer (mixed sites) completed an insomnia diagnostic interview at the perioperative phase (T1), as well as at 2 (T2), 6 (T3) 10 (T4), 14 (T5), and 18 (T6) months after surgery.
Results Findings revealed high rates of insomnia at baseline (59%), including 28% with an insomnia syndrome. The prevalence of insomnia generally declined over time but remained pervasive even at the end of the 18-month period (36%). Rates were greater in patients with breast (42% to 69%) and gynecologic (33% to 68%) cancer and lower in men with prostate cancer (25% to 39%) throughout the study. Nearly 15% of patients had a first incidence of insomnia during the study, and 19.5% experienced relapse. The evolution of symptoms varied according to sleep status. Remissions (patients becoming good sleepers) were much less likely for patients with an insomnia syndrome (10.8% to 14.9%) than for those with insomnia symptoms (42.0% to 51.3%). Most frequently (37.6%), patients with an insomnia syndrome at baseline kept that status throughout the 18-month period.
Conclusion Insomnia is a frequent and enduring problem in patients with cancer, particularly at the syndrome level. Early intervention strategies, such as cognitive- behavioral therapy, could prevent the problem from becoming more severe and chronic.
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