What Is the Main Idea?

Sleep disorders are reported in 30–50% of cancer patients, but the specific causes are unknown. A detailed series of questionnaires was given to 107 patients with various types of cancer to establish what the reasons might be. The open access paper written about the study and published in the journal Oncology Research and Treatment is titled “Why Do Our Cancer Patients Sleep So Badly? Sleep Disorders in Cancer Patients: A Frequent Symptom with Multiple Causes”. It discusses the importance of considering the causes of poor sleep when planning treatment.

What Else Can You Learn?

Learn about the stages of sleep and what constitutes a good sleep. Find out what you could talk to your physician about if you’re a cancer patient suffering from a sleep disorder, pain, depression, or anxiety.

What Is a Good Sleep?

Getting a good sleep is essential for our physical and mental well-being. We should try to get a good sleep every day. But what does “good” mean in this context?

A good sleep is one where our body and brain can recover from the day’s events. For this recovery to be effective, we need to give our body time to cycle through the four stages of sleep, ideally a few times.

  • Stage 1 of sleep is when your eyes are closed but you’re still a little bit aware of your surroundings. You might wake up or your leg or arm might twitch. It would be easy for someone to wake you. If you’re getting good sleep, this stage is short — maybe 10 minutes.
  • Stage 2 is the light sleep when your heart rate slows down and your core temperature declines. You could still be woken quite easily but you’re not aware of your surroundings. This stage can last up to 25 minutes.
  • Stage 3 is the period of sleep when your muscles are fully relaxed, your body is producing melatonin at a higher rate, and your core temperature has stabilized. It would be difficult to wake you. Your body and brain can start recovering from the day’s events during stage 3. It’s the first stage of regenerative sleep. It can last up to an hour.
  • REM sleep is the second stage of regenerative sleep. REM sleep is a period of more intense brain activity, faster breathing and an elevated heart rate. Dreams occur during this stage. The length of REM depends on what cycle of sleep you’re in. During the first cycle, REM might only be 10 minutes. If you get a full sleep, the final stage of REM can be an hour.

Cancer Patients Have Disrupted Sleep

Cancer is a source of considerable anxiety, stress and fear. What’s more, cancer may cause pain or other obvious physical symptoms. If you’ve ever lain awake at night because you’re anxious, stressed, depressed or afraid about something or because you have backache, a headache or other discomfort, the statement that cancer patients have difficulty getting a good night’s sleep may seem obvious. Even cancer patients themselves seem to think bad sleep is normal for them and they under-report it to doctors unless they are specifically asked about it.

As discussed in “Why Do Our Cancer Patients Sleep So Badly? Sleep Disorders in Cancer Patients: A Frequent Symptom with Multiple Causes”, there is a lot more to the story of why so many cancer patients sleep poorly — and importantly, a lot more that could be done to support them.

What Percentage of Cancer Patients Sleep Poorly?

In the medical literature, sleep disorders are reported in 30–50% of cancer patients. In this paper, 68% of patients reported a sleep disorder, with 44.9% reporting insomnia.

What Role Do Cancer Drugs Play?

Interestingly, medication was not found to have a significant impact on sleep in this study.

What Role Does Pain Play?

Pain is a major cause of sleep disorders. In this study, a markedly increased level of pain was found in the group of patients with sleep disorders. However, only 35.5% of them were taking a medication to alleviate the pain. The authors recommend that physicians should interview patients about pain and try to address it, focusing on optimizing pain therapy before prescribing sleeping pills.

The authors also note that when you can’t sleep, there is a knock-on effect on the intensity and frequency of pain. This vicious circle needs to be broken to give patients the regenerative rest they need.

What Role Do Depression and Anxiety Play?

In the study, 49.5% of the patients had mild or moderate depressive symptoms and most of these showed markedly more disrupted sleep. The authors recommend that if a patient says they’re not sleeping, physicians should ask about depression. Also, if a patient mentions depression but doesn’t mention not sleeping, the physician should check on their sleep quality.

As mentioned, anxiety is another source of disruption in sleep. In the study, this also proved true. Around 50% of the participants had moderate or extreme feelings of anxiety and almost all of them had a sleep disorder. What’s more, patients with a sleep disorder rated their anxiety as double that of patients without a sleep disorder. This again indicates that physicians should talk to their cancer patients about both anxiety and sleep.

Related to mental and emotional health were material concerns. Cancer patients who had lost their job or were afraid of losing their job reported sleep disturbances, as did the majority of those with financial stress.

What You Can Do

All the authors’ recommendations to physicians to talk about sleep-related issues can translate into topics for you to bring up first.

Therefore, if you are a cancer patient, be prepared to talk to your doctor clearly about pain, sleep, depression, anxiety and even personal worries. Give your doctor a clear picture of what you’re going through and how you’re sleeping. Make it clear you’d like to address pain before trying sleeping pills. Ask for support with mental health. If you aren’t sure why you can’t sleep, get your doctor to discuss it with you — they might have the answer.

Above all: Get the help you need to eliminate the barriers to that all-important regenerative sleep.

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