Insomnia is common among cancer patients undergoing chemo. The following article was reprinted from ASCO Cancer Advances with permission.
Researchers have found that 43 percent of patients undergoing chemotherapy for cancer in a clinical trial met the clinical criteria for insomnia syndrome and an additional 37 percent had insomnia symptoms, suggesting that the majority of patients (80 percent) experience sleep difficulties. This rate is approximately two to three times higher than that seen in the general population. Insomnia syndrome is defined as difficulty sleeping three or more times per week for at least a month, and can cause significant distress or impairment in daytime functioning. The study was published in the Journal of Clinical Oncology.
Prior studies have identified increases in sleep disturbances among people with cancer, but this is the first investigation to show an elevated risk of insomnia syndrome in people undergoing active cancer treatment with chemotherapy.
In this study, researchers performed a subset analysis on data from a prospective trial of 823 patients undergoing chemotherapy for a range of cancer types enrolled between 1997 and 1999. Researchers found that 43 percent of patients experienced insomnia syndrome and an additional 36.6 percent reported insomnia symptoms during cycle 1 of chemotherapy; during cycle 2, 35.2 percent experienced insomnia syndrome and an additional 33.1 percent reported insomnia symptoms. By comparison, the prevalence of insomnia syndrome in the general population ranges from 16 to 21 percent.
The prevalence of insomnia syndrome was highest among patients with lung cancer (50.8 percent) and among patients under age 58 (the median age of patients in the study). Patients with insomnia syndrome reported more depression (32.3 percent) and fatigue (45.5 percent) than those who reported sleeping well (10.4 percent and 30.8 percent, respectively).
The authors speculated that the side effects of cancer treatments as well as the stress and anxiety of a cancer diagnosis may contribute to insomnia, but this study did not examine the causes of patients’ insomnia. They also added that some chemotherapy drugs used today are different than those received by patients in this study and may therefore influence sleep patterns differently among patients today.
What This Means for Patients
This study shows that insomnia is very common among patients undergoing cancer treatment and is likely underdiagnosed. Patients who have difficulties sleeping should talk to their doctors, who can provide helpful tools and treatments, such as insomnia medication or referrals to a sleep clinic. Cognitive behavioral therapy for insomnia, exercise, and yoga are all beneficial, when they are feasible.