Sleep and Cancer

Abstract

Background/Objectives: Sleep issues are common in the general population, and these problems occur even more frequently for people with cancer. Sleep problems may pre-exist a patient's cancer diagnosis, and there is a growing interest in understanding the impact of sleep on cancer development and progression. Sleep disorders may impact cancer through altered metabolism, impacts on immune response, and alterations in hormones and gene expression. Sleep disorders may also arise after, or be aggravated by, an individual's cancer and cancer treatment. Treating a person with cancer's sleep disorder may help improve their healing, mental health, cognition, and overall resilience. Methods: Studies examining a variety of aspects of the relationship between sleep and cancer were found by searching the National Library of Medicine and characterized by their specific information provided on the relationship between sleep and cancer. Results: This review article summarizes our current understanding of the complex inter-relationship between sleep and cancer, the underlying mechanisms that create these connections, and the methods and impact of treating sleep issues in cancer patients. The article also outlines an approach to sleep complaints for clinicians caring for patients with cancer. Conclusions: Significant research is still needed to understand the full relationship between sleep disorders and cancer. The impact of sleep issues on cancer and of cancer on sleep appears to be specific to the tissue and the molecular type of cancer. The treatment of sleep disorders is multimodal, and offers a promising avenue to improve the health and quality of life of cancer patients.

Keywords: cancer; excessive sleepiness; insomnia; sleep; sleep disorders; sleep disruption.

Figure 1

This figure depicts the two process model. The homeostatic drive increases as a result of activity while awake and then is metabolized during sleep. This drive increases the drive for sleep. The circadian drive also increases through the day and opposes the homeostatic drive by promoting wakefulness. The circadian rhythm is accentuated by light, activity, food, and social interaction during the waking period.

Figure 2

This diagram demonstrates the variety of mechanisms by which sleep, sleep disruption, and sleep disorders may influence cancer development and progression.

Figure 3

Many factors can influence sleep. This diagram illustrates the variety of components involved in achieving good sleep and the domains by which sleep may be disrupted.