Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained?

Abstract

Although sleep is vital to all human functioning and poor sleep is a known problem in cancer, it is unclear whether the overall prevalence of the various types of sleep disorders in cancer is known. The purpose of this systematic literature review was to evaluate if the prevalence of sleep disorders could be ascertained from the current body of literature regarding sleep in cancer. This was a critical and systematic review of peer-reviewed, English-language, original articles published from 1980 through 15 October 2013, identified using electronic search engines, a set of key words, and prespecified inclusion and exclusion criteria. Information from 254 full-text, English-language articles was abstracted onto a paper checklist by one reviewer, with a second reviewer randomly verifying 50% (k = 99%). All abstracted data were entered into an electronic database, verified for accuracy, and analyzed using descriptive statistics and frequencies in SPSS (v.20) (North Castle, NY). Studies of sleep and cancer focus on specific types of symptoms of poor sleep, and there are no published prevalence studies that focus on underlying sleep disorders. Challenging the current paradigm of the way sleep is studied in cancer could produce better clinical screening tools for use in oncology clinics leading to better triaging of patients with sleep complaints to sleep specialists, and overall improvement in sleep quality.

Using a personalized measure (Patient Generated Index (PGI)) to identify what matters to people with cancer

“…Other studies that have used the PGI in cancer samples also found this wide range of areas [9,19]. Our findings are concordant with the literature on the importance of fatigue, sleep, and pain to QOL, as the most recent systematic reviews endorsed their importance [48][49][50][51][52][53].…”

Melatonin-Induced Oncostasis, Mechanisms and Clinical Relevance

“…Sleep complains included excessive fatigue (44% of patients), restlessness leg syndrome (41%), insomnia (31%) and excessive diurnal somnolence (28%) [174]. It must be noted however that an imprecise conceptualization of sleep has led to narrowly focused interventions being diffusely targeted to symptoms, rather than focused and specific to one or more sleep disorders underlying those symptoms [175]. This is important because although many interventions for sleep in cancer have shown efficacy, the majority of these studies are too targeted to undefined subtypes of insomnia.…”

Sleep disorders in breast cancer survivors

“…To our knowledge, no studies have conducted an in-depth evaluation of sleep problems in BCS to ascertain if selfreported symptoms suggest possible underlying sleep disorders [21]. The purpose of this study was to evaluate the feasibility, acceptability, and initial results of a structured assessment of sleep disorders in BCS.…”

“…Identifying sleep disorders is very important because different disorders require different interventions even if symptoms overlap. Most intervention studies in BCS have tested the use of cognitive-behavioral therapies to target undefined subtypes of insomnia, [16,21] without screening out other sleep disorders that require additional disorder specific therapies. Because the focus has been on symptoms of poor sleep, BCS may be receiving treatments for sleep problems that are inappropriate or inadequate.…”