MedicalResearch: What is the background for this study? What are the main findings?
Dr. Savard: This paper reports on a secondary analysis of an 18-month longitudinal study initially conducted in 962 patients about to receive surgery for various types of cancer. The main results of this larger study indicated that insomnia is a significant problem in cancer patients. More precisely, it was found to affect up to 59% of patients at the peri-operative period. In addition, 32% of patients who were good sleepers developed insomnia symptoms at some point during the study (Savard et al., 2009; Savard et al., 2011).
The goal of this particular analysis was to determine the role of cancer treatments and their side effects in triggering/aggravating insomnia symptoms during the 18-month follow-up. Study participants completed questionnaires assessing insomnia severity and somatic symptoms at baseline, as well as 2, 6, 10, 14 and 18 months later. This analysis was conducted separately in women treated for breast cancer (n=465) and men treated for prostate cancer (n=263). In breast cancer patients, chemotherapy and radiation therapy, but not hormone therapy, were found to be associated with increased insomnia severity. This deleterious effect appeared to be due to a number of side effects (e.g., nausea, night sweats, urinary symptoms). In prostate cancer patients, androgen-deprivation therapy was associated with aggravation of insomnia, an effect that was mainly due to the occurrence of night sweats.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Savard: That adjuvant cancer treatments, through their side effects, can have a deleterious impact on sleep. It also suggests that it is important to closely monitor and manage treatments’ side effects to prevent the occurrence or the aggravation of insomnia. Indeed, insomnia is associated with an array of negative consequences including impairments in daytime functioning and quality of life, as well as an increased risk to develop other psychological disorders such as depressive and anxiety disorders.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Savard: Future studies should investigate whether certain types of chemotherapy and hormone therapy are associated with a greater risk to develop insomnia and the role of other possible risk factors (e.g., psychological distress, change in sleeping habits). Clinical trials aiming at preventing the development of insomnia in patients initiating adjuvant treatments are also needed.
Savard, J., Ivers, H., Villa, J., Caplette-Gingras, A., & Morin, C. M. (2011). Natural course of insomnia comorbid with cancer: An 18-month longitudinal study. Journal of Clinical Oncology, 29, 3580-3586.
Savard, J., Villa, J., Ivers, H., Simard, S., & Morin, C. M. (2009). Prevalence, natural course and risk factors of insomnia comorbid with cancer over a 2-month period. Journal of Clinical Oncology, 27, 5233-5239.
Cancer treatments and their side effects are associated with aggravation of insomnia: Results of a longitudinal study.
MedicalResearch.com Interview with: Josée Savard, Ph.D. (2015). Cancer Treatments Can Trigger Insomnia