From the Guidelines
Sleep plays a crucial role in cancer recurrence, as sleep disturbances can lead to fatigue, anxiety, and depression, which can negatively impact cancer outcomes.
Role of Sleep in Cancer Recurrence
- Sleep disturbances, including insomnia and excessive sleepiness, affect 30% to 50% of patients with cancer and survivors, often in combination with fatigue, anxiety, or depression 1.
- Improvements in sleep lead to improvements in fatigue, mood, and quality of life, which can positively impact cancer outcomes 1.
- Exercise and physical activity may improve sleep in patients with cancer and survivors, with one randomized controlled trial showing that a standardized yoga intervention improved sleep quality and daytime functioning in survivors with moderate to severe sleep disruption 1.
- Melatonin has been studied as a potential treatment for sleep disturbances in cancer patients, but the evidence is limited and inconclusive, with one trial showing no impact on anxiety in patients with colorectal cancer 1.
Management of Sleep Disturbances
- Sleep hygiene education, physical activity, psychosocial interventions, and pharmacologic treatments are recommended for the management of sleep disorders in cancer survivors 1.
- Screening and diagnosis of sleep disorders are crucial, as insomnia is often overlooked in cancer practice and patients may fail to report it 1.
- A meta-analysis of randomized controlled trials showed that exercise improved sleep at a 12-week follow-up in patients who had completed active cancer treatment, highlighting the importance of physical activity in improving sleep outcomes 1.
From the Research
Role of Sleep in Cancer Recurrence
- Sleep plays a crucial role in overall health, and poor sleep has been linked to various systemic diseases, including cancer 2.
- A bidirectional connection exists between sleep and cancer, with sleep disorders potentially contributing to cancer risk and tumor growth 3.
- Sleep deprivation has been shown to promote cancer progression, particularly in colon cancer, by impairing intracellular lipolysis and leading to lipid droplet accumulation in cancer cells 4.
Sleep Disorders and Cancer Recurrence
- Sleep disorders are common among cancer patients and can negatively impact quality of life, survival, and response to therapy 3, 5.
- Specific sleep disorders, such as insomnia and sleep apnea, have been linked to increased risk of cancer recurrence and mortality 5.
- The relationship between sleep disorders and cancer recurrence is complex and influenced by various factors, including tumor type, treatment regimen, and patient demographics 2, 3.
Mechanisms Linking Sleep and Cancer Recurrence
- Sleep deprivation can lead to changes in physiology and behavior that are detrimental to health, including altered immune function and increased inflammation 2.
- The KynA-P4HA2-HIF-1α axis has been identified as a key mediator of the relationship between sleep deprivation and colon cancer metastasis 4.
- Shorter sleep duration has been associated with more aggressive breast cancer and higher OncotypeDX recurrence scores, particularly in postmenopausal women 6.