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Cancer Survivors' Sleep Is Affected Long After Treatment

Posted by Manuela Boyle on 20 February 2022
Cancer Survivors' Sleep Is Affected Long After Treatment

Once the stress of a cancer diagnosis and its intensive treatments have passed, the hope is that life can return to normal. But we know that this is not true for many people who have had treatments for cancer, and sleep is often impacted for a long time after treatment.

Researchers at the American Cancer Society studied responses from 1,903 cancer survivors from across the US. These survivors were diagnosed with cancers such as breast cancer or prostate cancer about nine years before the study. As part of the research, these cancer survivors were asked questions about their sleep and cancer history, and their overall physical, mental, and social health. Even though these men and women had been diagnosed with cancer almost a decade ago, a staggering 51% reported that their sleep has been disturbed over the prior month!

Why do sleep problems continue after cancer?

Findings suggest that the residual effects of cancer may continue to negatively affect a survivor’s sleep. Poor sleepers were more likely to report that they had more physical and emotional distress. Perhaps more unexpected were results that showed survivors who were sleeping poorly were also more likely to be having some economic hardship, and expressed worries about money and a fear of cancer recurrence.

It is critical that cancer survivors raise the issue with their medical team. There are a number of different sleep disorders that require thorough evaluation and accurate diagnosis. For example, insomnia disorder and obstructive sleep apnea are common among middle-aged and older men and women. If sleep disorders are left untreated, they can lead to a host of negative health outcomes, including cognitive dysfunction, mood disorders, cardiovascular disease and more.  

Medication is a common treatment to help sleep, but it’s not always the best choice, as there are concerns about medication tolerance (needing a larger dose to get the same effect), dependence, and daytime side effects. In the study previously mentioned, 28% of respondents reported using a sleep medication within the past month. While there is certainly a time and a place for medications designed to help with sleep, long-term use is not advised for cancer survivors, especially if the problem is insomnia disorder.

Rather, cognitive-behavioral therapy for insomnia (or CBT-I) is recommended as first-line treatment.  Instead of masking the symptom (poor sleep), CBT-I target the problematic sleep behaviours and thoughts that continue to cause a person to sleep poorly. For example, a patient receiving radiation therapy may be fatigued during the day and take extended naps. During active treatment, this can be helpful. But they may develop a habit of continuing to take naps, which can affect their ability to fall asleep at night. As part of CBT-I, cancer survivors can expect to track their sleep, develop a sleep period that is better aligned with how much sleep they need, and change the thoughts that can make it more difficult to fall asleep or stay asleep.

Author:Manuela Boyle
Tags:NewsCancerCancer survivorsSleepWhat's Next?

Associations

  • The Institute for Functional Medicine
  • Society for Integrative Oncology
  • Naturopaths and Herbalists Association of Australia
  • Australian Traditional-Medicine Society
  • British Naturopathic Association