Are sleep continuity disturbance and fatigue prodromal symptoms of cancer development?

Abstract

Sleep continuity disturbance (also known as insomnia) and fatigue are common complaints of individuals diagnosed with cancer. Traditionally, many have believed that sleep continuity disturbance and fatigue are caused, in large measure, by the impact of the cancer diagnosis and treatment. Recent prospective research suggests however, that sleep continuity disturbance and fatigue may actually precede a cancer diagnosis. We suggest that sleep continuity disturbance and fatigue may in fact represent prodromal symptoms of cancer. We review the current perspectives of this sequence of events and present a revised schematic that accounts for the role of biological, behavioural, and cognitive factors that contribute to the development and maintenance of sleep continuity disturbances in cancer patients. Monitoring emergent and unexplained patient-reported fatigue, sleepiness, and insomnia may serve as early warning signs of new onset cancer, providing opportunity for early detection and early intervention.

Longitudinal Changes in Sleep: Associations with Shifts in Circulating Cytokines and Emotional Distress in a Cancer Survivor Population

“…Sleep disturbance is prevalent in cancer patients and survivors, and understanding of its connection with the PNI could produce more effective interventions and improve QOL. Although a few groups have published extensive studies on stress and sleep in the context of cancer [ 2 , 68 – 71 , 72 – 74 ], few studies have examined the relationship of sleep, distress, and immunity in cancer patients [ 75 – 77 ] or cancer survivors [ 2 , 78 , 79 ], and none have been focused on cervical cancer patients or survivors.…”

Short‐ and long‐term mortality following hypnotic use

“…An association of hypnotics with excess mortality may arise due to confounding by indication because chronic illness increases the need for hypnotic use. Impaired sleep has indeed been suggested to represent an early sign of cancer and often precedes a cancer diagnosis (Garland, Irwin, Posner, & Perlis, 2018). Symptomatic treatment, including insomnia treatment, is also one of the primary goals in palliative care.…”

A circadian rhythm-related gene signature associated with tumor immunity, cisplatin efficacy, and prognosis in bladder cancer

“…Circadian rhythm dysregulation was often accompanied by the alternation of clock gene expression, which disrupted the normal cell cycle and thus directly promoted tumor cell proliferation [ 23 , 24 ]. Melatonin, acting as a critical hormone regulating circadian rhythm, was significantly associated with the risk of breast cancer, lung cancer, and cervical carcinoma from previous evidence-based medical researches [ 25 ]. The findings above suggested circadian rhythm played an important role in tumorigenesis and tumor development.…”