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Advanced cancer patients prone to poor sleep quality, daytime sleepiness, Emory study shows
June 13, 2007Patients with advanced-stage cancer experience very poor sleep quality and often have troubling staying awake, says Emory University researcher Kathy Parker, PhD, RN.
Preliminary findings from the cancer sleep study will be presented June 12 at the annual meeting of the Associated Professional Sleep Societies (APSS) convened in Minneapolis.
The study provides the first comprehensive description of sleep and wake patterns of cancer patients using continuous polysomnography (PSG) data, deemed the gold standard in objective physiological measurement of sleep. It involved 114 advanced cancer patients with an average age of 51.1 years. Study patients underwent continuous sleep monitoring, or PSG, for approximately 42 hours in their home environments.
Results showed that study participants experienced severe difficulty with "state maintenance," or the ability to maintain both the sleep and waking states. Overall they had reduced quantity and quality of nocturnal sleep and episodes of sleep scattered throughout the day. Increased amounts of daytime sleep significantly and adversely affected several key parameters of nocturnal sleep quantity and quality.
However, women, Caucasians, and those who were married/partnered and had more education fared better in nocturnal sleep than other study participants. In addition, relative to breast cancer, lung cancer also may be a risk factor for poor sleep.
"While it's unclear what definitively causes cancer patients to have trouble sleeping and staying awake, demographic factors and the type of cancer may be contributing factors," says Dr. Parker, Emory Nell Hodgson Woodruff School of Nursing professor, co-director of the Emory Sleep Center and study principal investigator.
Symptoms such as depression, pain and fatigue may also play a role in the disruption of sleep among this population, Dr. Parker notes. Opioids, the mainstay of treatment for pain, may have adverse effects on sleep in cancer patients by specifically suppressing deep sleep and dream sleep and altering the normal circadian rhythms, she says. Antidepressants, too, have been shown to cause either sleepiness or insomnia. The study, funded by the National Institutes of Health/National Institute of Nursing Research (NIH/NINR), is limited by the fact that contributing variables were not included in the analyses, Dr. Parker says. Additional research is needed to determine if the sleep state instability observed in this study is related to primary sleep disorders that are common in this age group such as sleep apnea and periodic limb movement disorder.
Emory University
Results showed that study participants experienced severe difficulty with "state maintenance," or the ability to maintain both the sleep and waking states. Overall they had reduced quantity and quality of nocturnal sleep and episodes of sleep scattered throughout the day. Increased amounts of daytime sleep significantly and adversely affected several key parameters of nocturnal sleep quantity and quality.
However, women, Caucasians, and those who were married/partnered and had more education fared better in nocturnal sleep than other study participants. In addition, relative to breast cancer, lung cancer also may be a risk factor for poor sleep.
"While it's unclear what definitively causes cancer patients to have trouble sleeping and staying awake, demographic factors and the type of cancer may be contributing factors," says Dr. Parker, Emory Nell Hodgson Woodruff School of Nursing professor, co-director of the Emory Sleep Center and study principal investigator.
Symptoms such as depression, pain and fatigue may also play a role in the disruption of sleep among this population, Dr. Parker notes. Opioids, the mainstay of treatment for pain, may have adverse effects on sleep in cancer patients by specifically suppressing deep sleep and dream sleep and altering the normal circadian rhythms, she says. Antidepressants, too, have been shown to cause either sleepiness or insomnia. The study, funded by the National Institutes of Health/National Institute of Nursing Research (NIH/NINR), is limited by the fact that contributing variables were not included in the analyses, Dr. Parker says. Additional research is needed to determine if the sleep state instability observed in this study is related to primary sleep disorders that are common in this age group such as sleep apnea and periodic limb movement disorder.
Emory University
Cancer Patient News and Current Cancer Patient Events RSSVariation of normal protein could be key to resistance to common cancer drug
Researchers at the Moores Cancer Center at the University of California, San Diego (UC SD) in La Jolla have found evidence explaining why a common chemotherapy drug, cisplatin, may not always work for every cancer patient. They have shown that when a variant version of a key protein that normally causes cell death is active, patients may be resistant to the cancer-killing drug.
Targeted radiation therapy can control limited cancer spread
Precisely targeted radiation therapy can eradicate all evidence of disease in selected patients with cancer that has spread to only a few sites, suggests the first published report from an ongoing clinical trial.
Plants make vaccine for treating type of cancer in Stanford study
Plants could act as safe, speedy factories for growing antibodies for personalized treatments against a common form of cancer, according to new findings from the Stanford University School of Medicine. The findings came in the first human tests of an injectable vaccine grown in genetically engineered plants.
First worldwide analysis of cancer survival finds wide variation between countries
Cancer survival varies widely between countries according to a worldwide study published online today in Lancet Oncology.* More than 100 investigators contributed to the study.
Improving understanding of cell behaviour in breast cancer
The invasion and spread of cancer cells to other parts of the body, known as metastasis, is a principal cause of death in patients diagnosed with breast cancer.
Improving understanding of cell behaviour in breast cancer
The invasion and spread of cancer cells to other parts of the body, known as metastasis, is a principal cause of death in patients diagnosed with breast cancer.
M. D. Anderson nurse addresses lymphedema in breast cancer patients and survivors
A poster session presented today by The University of Texas M. D. Anderson Cancer Center at the Oncology Nurses Society 33rd Annual Congress, found that early nursing intervention and implementation of effective strategies can lead to a decrease in the incidence of lymphedema, better management of chronic lymphedema and improved quality of life in breast cancer patients.
Advanced-stage ovarian cancer patients with BRCA live longer, may respond better to treatment
Two abstracts underscoring the importance of testing for BRCA1/2 mutations in women with ovarian cancer were presented at this week's Society of Gynecologic Oncologists 39th Annual Meeting on Women's Cancers, by researchers from The University of Texas M. D. Anderson Cancer Center.
Small RNAs can prevent spread of breast cancer
Howard Hughes Medical Institute researchers have identified small pieces of ribonucleic acid (RNA) that suppress the spread of breast cancer to the lungs and bone. The new research shows that the most invasive and aggressive human breast cancer tumors are missing three critical microRNA molecules.
Cancer-resistant mouse discovered
A mouse resistant to cancer, even highly-aggressive types, has been created by researchers at the University of Kentucky.
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