The course of cancer-related insomnia: don't expect it to disappear after cancer treatment

Schieber, Katharina; Niecke, Alexander; Geiser, Franziska; Erim, Yeşim; Bergelt, Corinna; Büttner-Teleagă, Antje; Maatouk, Imad; Stein, Barbara; Teufel, Martin; Wickert, Martin; Wuensch, Alexander; Weis, Joachim

doi:10.1016/j.sleep.2019.02.018

Cited by 46 publications

(44 citation statements)

References 39 publications

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“…Participants’ perceptions of the management of insomnia were also explored. Consistent with previous findings, routine sleep assessment was absent in cancer care, and insomnia, when reported, was primarily treated with hypnotic medications (Coles et al ., 2017; Schieber et al ., 2019). More alarmingly, all participants highlighted that sleep was never discussed by clinicians and that they were never informed that disrupted sleep was a common occurrence following cancer diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Insomnia is diagnostically defined by the DSM‐5 as difficulty with sleep initiation, maintenance, and/or non‐restorative sleep with associated impairment or significant distress (American Psychiatric Association, 2013). Once established, insomnia commonly develops an unremitting and chronic course (Schieber et al ., 2019) and has often been described by cancer survivors as being more challenging than cancer diagnosis and subsequent treatment (Palesh et al ., 2010).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the prevalence and potential impact of cancer‐related insomnia, its management in clinical care remains suboptimal (Zhou, Clark, Recklitis, Obenchain, & Loscalzo, 2018). It is often presumed by both clinicians and cancer patients to be a transient response to cancer diagnosis and treatment that will ultimately self‐resolve (Schieber et al ., 2019). Consequently, insomnia is not routinely screened for in cancer clinics and is a subject that patients rarely discuss with their oncology team (Coles et al ., 2017; Schieber et al ., 2019).…”

Section: Introductionmentioning

confidence: 99%

“…It is often presumed by both clinicians and cancer patients to be a transient response to cancer diagnosis and treatment that will ultimately self‐resolve (Schieber et al ., 2019). Consequently, insomnia is not routinely screened for in cancer clinics and is a subject that patients rarely discuss with their oncology team (Coles et al ., 2017; Schieber et al ., 2019). Evidence suggests that clinicians perceive themselves to be inadequately trained or qualified to assess and treat sleep disturbance in cancer patients, reducing the likelihood that it will be on the agenda during clinic appointments (Johnson et al ., 2016; Schieber et al ., 2019).…”

Section: Introductionmentioning

confidence: 99%

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Living with persistent insomnia after cancer: A qualitative analysis of impact and management

Reynolds-Cowie

Fleming

2020

British J Health Psychol

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ObjectivesTo conduct a qualitative exploration of the lived experience of insomnia disorder and its management amongst a sample of mixed‐diagnoses cancer survivors.MethodsTwenty‐seven cancer survivors with persistent insomnia were recruited to this qualitative study following completion of treatment for breast (12), prostate (7), colorectal (7), and gynaecological (1) cancers. Eleven males and 16 females (mean age 62 years), who met DSM‐5 criteria for insomnia disorder, contributed to one of four focus group discussions, designed to explore the lived experience of persistent insomnia and its management within cancer care services.ResultsPoor sleep was a persistently troubling complaint for participants, long after the completion of active cancer treatment. The impact of insomnia was significant for all participants, with six key domains emerging as those most affected: temperament, sociability, physical well‐being, cognitive functioning, relationships, and psychological well‐being. In terms of insomnia management, participants frequently resorted to unfruitful self‐management strategies, due to the lack of professional insomnia expertise within cancer care settings. Three main themes emerged in relation to insomnia management: self‐management, seeking professional intervention, and a lack of focus on sleep. A lack of clinician understanding of the importance of sleep health and the poor availability of evidence‐based insomnia interventions, such as cognitive behavioural therapy for insomnia (CBT‐i), were highlighted as important gaps in cancer care.ConclusionsInsomnia was found to have a detrimental and pervasive impact on cancer survivors’ quality of life, which persisted long into survivorship. There is an absence of professional attention to sleep throughout the cancer care trajectory, contributing to its prevalence, persistence, and impact. In order to break this cycle, sleep health should be integrated as a key aspect of cancer treatment and rehabilitation, much like maintaining a healthy diet and appropriate levels of physical activity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Living with persistent insomnia after cancer: A qualitative analysis of impact and management

Reynolds-Cowie

Fleming

2020

British J Health Psychol

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show abstract

“…15 Insomnia is highly persistent, especially in female cancer patients. 16 Insomnia has been associated with many clinical and psychological parameters, especially with fatigue. 16 Sleep quality was assessed by the Insomnia Severity Index (ISI), which incorporates additional items on sleep quality and specific sleep-related daytime impairments (on daytime fatigue, cognitive functioning, mood, interpersonal relationship, and daily activities).…”

Section: Assessmentsmentioning

confidence: 99%