Prostate Cancer and Sleep Disorders: A Systematic Review

Abstract

Prostate cancer (PCa) treatment involves multiple strategies depending on the disease’s stage. Androgen deprivation therapy (ADT) remains the gold standard for advanced and metastatic stages. Sleep quality has been suggested as being additionally influenced also by local radiotherapy, prostatectomy and androgen-receptor (AR)-targeted agents. We performed a systematic review exploring the landscape of studies published between 1 January 1990 and 31 July 2021, investigating sleep disturbances in PCa patients receiving active treatments, including the influence of hormonal therapy on sleep quality as a factor affecting their quality of life. Out of 45 articles identified, 16 studies were selected, which recruited patients with PCa, undergoing active treatment in either a prospective longitudinal or cross-sectional study. Development of sleep disorders or changes in sleep quality were reported in 14 out of 16 trials included. Only five trials included objective measurements such as actigraphy, mostly at one time point and without a baseline assessment. Limitations to be addressed are the small number of existing trials, lack of randomized trials and heterogeneity of methodologies used. This systematic review outlines the lack of prospective trials investigating sleep disorders, with a rigorous methodology, in homogeneous cohorts of PCa patients. Future trials are needed to clarify the prevalence and impact of this side effect of PCa treatments.

Understanding Sleep Disturbances in Prostate Cancer—A Scientometric Analysis of Sleep Assessment, Aetiology, and Its Impact on Quality of Life

“…Another citing article in this cluster was written by Sparasci et al [ 64 ]. They reviewed sleep disturbances and prostate cancer, paying particular attention to prostate cancer treatments and any potential sleep-related effects.…”

How to Improve the Quality of Life of Patients with Prostate Cancer Treated with Hormone Therapy?

“…Hot flashes can be associated with sleep disturbance and may lead to a deterioration in quality of life. 85 Moreover they may decrease compliance to ADT and are a major contributor to its discontinuation. 24 …”

Circadian Clock Dysregulation and Prostate Cancer: A Molecular and Clinical Overview

“…It is estimated that 25% to 40% of prostate cancer patients experience insomnia, and ADT, radiation therapy, and prostatectomy are all believed to play a role. 107 , 108 There is certainly a lack of trials examining sleep disorders in prostate cancer patients, and thus, a dearth of prospective data on the topic. From reviewing the limited retrospective literature, as Sparasci et al most recently completed, 14 of 16 trials demonstrated development of sleep disorders or changes in sleep quality in this patient population.…”

“…From reviewing the limited retrospective literature, as Sparasci et al most recently completed, 14 of 16 trials demonstrated development of sleep disorders or changes in sleep quality in this patient population. 107 Hot flashes and nocturia are prominent factors that play a role in contributing to insomnia in men with prostate cancer undergoing treatment. Patients on ADT report greater hot flash incidence and more severe and clinically significant sleep disturbances when measured on the Insomnia Severity Index.…”