Skip to content

Cancer Health Center

Font Size

Sleep Disorders (PDQ®): Supportive care - Health Professional Information [NCI] - Overview

Sleep disturbances occur in about 10% to 15% of the general population [1] and are often associated with situational stress, illness, aging, and drug treatment.[2] It is estimated that one-third to one-half of people with cancer experience sleep disturbance.[3,4] Physical illness, pain, hospitalization, drugs and other treatments for cancer, and the psychological impact of a malignant disease may disrupt the sleeping patterns of persons with cancer.[5] Poor sleep adversely affects daytime mood and performance. In the general population, persistent insomnia has been associated with a higher risk of developing clinical anxiety or depression.[6] Sleep disturbances and, ultimately, sleep-wake cycle reversals can be early signs of a developing delirium. (Refer to the PDQ summary on Delirium for more information.) Adequate sleep may increase the cancer patient's pain tolerance.

Sleep consists of two phases: rapid eye movement (REM) sleep and non-REM (NREM) sleep.[7] REM sleep, also known as dream sleep, is the active or paradoxic phase of sleep in which the brain is active. NREM sleep is the quiet or restful phase of sleep. NREM, also referred to as slow wave sleep, is divided into four stages of progressively deepening sleep based on electroencephalogram findings.

Recommended Related to Cancer

I Had the Cancer No One Talks About

By Darci Picoult It began with a bump. The size of a pinhead. Innocuous. An innocuous little pinhead of a bump on my vulva. Given that my gynecologist said the bump was probably nothing, I laughed it off. Which, in turn, made my bump mad. Very mad. It wanted my attention. And so it grew. I smeared it in medicine. It grew more. More medicine. More growth. Hanukkah came. Then Christmas. A war raged between us. I went to battle in the middle of the night with salt baths and creams. Prayed for its departure...

Read the I Had the Cancer No One Talks About article > >

The stages of sleep occur in a repeated pattern or cycle of NREM followed by REM, with each cycle lasting approximately 90 minutes. The sleep cycle is repeated four to six times during a 7- to 8-hour sleep period.[7] The sleep-wake cycle is dictated by an inherent biological clock or circadian rhythm. Disruptions in individual sleep patterns can disrupt the circadian rhythm and impair the sleep cycle.[8]

Five major categories of sleep disorders have been defined by the Sleep Disorders Classification Committee of the American Academy of Sleep Medicine:[9]

  1. Disorders of initiating and maintaining sleep (insomnias).
  2. Sleep-related breathing disorders (sleep apnea).
  3. Disorders of excessive somnolence (hypersomnias).
  4. Disorders of the sleep-wake cycle (circadian rhythm sleep disorders).
  5. Dysfunctions associated with sleep, sleep stages, or partial arousals (parasomnias).

In this summary, unless otherwise stated, evidence and practice issues as they relate to adults are discussed. The evidence and application to practice related to children may differ significantly from information related to adults. When specific information about the care of children is available, it is summarized under its own heading.

References:

  1. National Sleep Foundation.: Can't Sleep? What To Know About Insomnia. Arlington, Va: National Sleep Foundation, 2011. Available online. Last accessed January 3, 2013.
  2. Sateia MJ, Pigeon WR: Identification and management of insomnia. Med Clin North Am 88 (3): 567-96, vii, 2004.
  3. Palesh OG, Roscoe JA, Mustian KM, et al.: Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program. J Clin Oncol 28 (2): 292-8, 2010.
  4. Savard J, Morin CM: Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 19 (3): 895-908, 2001.
  5. Berger AM: Update on the state of the science: sleep-wake disturbances in adult patients with cancer. Oncol Nurs Forum 36 (4): E165-77, 2009.
  6. Ohayon MM, Caulet M, Lemoine P: Comorbidity of mental and insomnia disorders in the general population. Compr Psychiatry 39 (4): 185-97, 1998 Jul-Aug.
  7. Hirshkowitz M: Normal human sleep: an overview. Med Clin North Am 88 (3): 551-65, vii, 2004.
  8. Hrushesky WJ, Grutsch J, Wood P, et al.: Circadian clock manipulation for cancer prevention and control and the relief of cancer symptoms. Integr Cancer Ther 8 (4): 387-97, 2009.
  9. American Academy of Sleep Medicine.: The International Classification of Sleep Disorders: Diagnostic & Coding Manual. 2nd ed. Westchester, Ill: American Academy of Sleep Medicine, 2005.

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

    WebMD Public Information from the National Cancer Institute

    Last Updated: September 04, 2014
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
    1
    Next Article:

    Today on WebMD

    Colorectal cancer cells
    New! I AM Not Cancer Facebook Group
    Lung cancer xray
    See it in pictures, plus read the facts.
     
    sauteed cherry tomatoes
    Fight cancer one plate at a time.
    Ovarian cancer illustration
    Real Cancer Perspectives
     
    Jennifer Goodman Linn self-portrait
    Blog
    what is your cancer risk
    HEALTH CHECK
     
    colorectal cancer treatment advances
    Video
    breast cancer overview slideshow
    SLIDESHOW
     
    prostate cancer overview
    SLIDESHOW
    lung cancer overview slideshow
    SLIDESHOW
     
    ovarian cancer overview slideshow
    SLIDESHOW
    Actor Michael Douglas
    Article