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Sleep and Recurrence

Posted 6/30/2015

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  Very honestly, I have been somewhat hesitant about sharing this study about sleep and the risk of cancer recurrence. First reason is that I am, blessedly, a world class sleeper. It makes my husband nuts that I am always asleep less than five minutes after putting my head on the pillow, and that I rarely awaken during the night. The only time in my life that sleep has been a recurring issue was during the last few months of my first marriage; that was one of the biggest indicators that I really had a big problem. Otherwise, I have slept soundly through all of life's other crises--maybe that suggests that I am shallow in some way, but it certainly has meant that I have been better rested and better able to cope during the day.

  The second reason for my hesitance was that this feels like an endless cycle: you can't sleep because you are worried about recurrence and then you are worried about not sleeping and then you worry more about a recurrence and sleep even less well etc. etc. etc. We all know that anxiety disrupts sleep, and the more distressed that we are, the more elusive are those Zs.

  The usual advice is don't stay in bed if you aren't sleeping. Get out, have a cup of herbal tea or a glass or milk and read for a few minutes until (hopefully) you are sleepy. No television. No computer. The other standard advice is to establish a bedtime routine and stick to it.

  Here is the start and a link to this article from Medscape:

To Recur, To Sleep: There's a Rub for Cancer Survivors
Roxanne Nelson, BSN, RN

Cancer survivors often fear disease recurrence, and this can affect the quality of their sleep, according to a new report. In a survey of 67 cancer survivors, 52% reported poor sleep quality during the previous month. People with some college education and those more afraid of a recurrence appeared to be at greater risk for poor sleep.
The survey results were published in the June issue of the Journal of Psychosocial Oncology.
"Previous literature suggests that both sleep and fear of cancer recurrence are significant, and often unaddressed, concerns in cancer survivorship," said lead author Julie Berrett-Abebe, LICSW, from the School of Social Work at Simmons College in Boston.
There are significant clinical implications from this survey, she and her colleagues point out. Although sleep quality is often categorized as a physical symptom of illness, these findings support the fact that emotions and cognition affect sleep quality.
"To provide holistic care in cancer survivorship, I think medical providers should ask about emotional concerns, such as the fear of cancer recurring, and physical concerns, such as sleep," Berrett-Abebe told Medscape Medical News. "For survivors with higher levels of fear of cancer recurrence, a referral to a mental health professional to specifically address this might have an impact on sleep."
Clinicians working with patients who have received cancer treatment should be "openly asking about their concerns and worries about progression and recurrence," said Helen L. Coons, PhD, ABPP, president and clinical director of Women's Mental Health Associates in Denver.
"They should also be asking about the quantity and quality of their sleep," she told Medscape Medical News.
Providers should be inviting patients throughout the course of the disease to bring up concerns about sleeping, especially if they are struggling with intrusive thoughts about disease progression, Dr Coons explained. "Anxiety is understandable in this population, but problems occur when anxiety becomes so intrusive that the patient is up at night," she said.

And, to make it worse, here is another study from the American Society of Sleep Medicine that suggests that poor sleep prior to diagnosis may increase the risk of recurrence. Now that is sure to keep you awake!

Sleep duration and quality may impact cancer survival rate

Findings could motivate and empower cancer patients to improve their sleep patterns (NOTE FROM HESTER: AND JUST HOW, PRAY TELL, DO THEY SUGGEST EMPOWERING CANCER PATIENTS TO IMPROVE SLEEP?)

DARIEN, IL - A new study suggests that pre-diagnostic short sleep duration and frequent snoring were
associated with significantly poorer cancer-specific survival, particularly among women with breast cancer.
Results show that stratified by cancer site, short sleep duration and frequent snoring were associated with
significantly poorer breast cancer-specific survival.
"Our results suggest that sleep duration is important for breast cancer survival, particularly in women who
snore," said lead author Amanda Phipps, assistant professor of epidemiology at the University of Washington
in Seattle, Wash. and assistant member at the Fred Hutchinson Cancer Research Center.
The research abstract was published recently in an online supplement of the journal Sleep and will be
presented Wednesday, June 10, in Seattle, Washington, at SLEEP 2015, the 29th annual meeting of the
Associated Professional Sleep Societies LLC.


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