Wednesday, April 22, 2015

When You Have Cancer and Can't Sleep By Anna Medaris Miller

Traci Gordon never had a problem falling asleep or staying asleep. In fact, she has a sleep disorder that causes her to sleep too much. "I could sleep through a whole weekend," Gordon says. That all changed when Gordon, a 47-year-old administrative assistant in New York, began chemotherapy for breast cancer about seven years ago. The treatment threw her body into an artificial state of menopause, which caused unrelenting night sweats. "My memory of it was waking up five, six, seven times a night, absolutely dripping," Gordon says. Each time, she would change her clothes, stand in front of the air conditioner and wonder how much of her fatigue was caused by the cancer, how much was caused by the treatment and how much was caused by her inability to sleep through the night. "It was really having an impact on top of everything else," she says. Sleep problems during cancer are ubiquitous, affecting up to 80 percent of people undergoing chemotherapy, says Oxana Palesh, an assistant professor in the Department of Psychiatry and Behavioral Sciences at Stanford University Medical Center who develops and tests sleep interventions for cancer patients and survivors. One of her studies found that insomnia is about three times more prevalent among cancer patients being treated with chemotherapy than it is in the general population. When you have cancer, Palesh says, "it's much more common to have sleep problems than not." But at the same time, sleeping well during cancer treatment is critically important in fighting the disease. Without solid rest, the body's level of cortisol -- known as "the stress hormone" -- goes up and the count of "natural killer cells," or NK cells, that help fight cancer go down, says Dr. Laeeq Shamsuddin, medical director of the sleep clinic at Cancer Treatment Centers of America at Midwestern Regional Medical Center in Zion, Illinois. For Kym Sinclair, a 31-year-old nurse in Santa Cruz, California, some of the most significant sleep disruptions from cancer were psychological. As she began chemotherapy, Sinclair struggled with side effects, including bone aches, vomiting, nausea, gastrointestinal distress and the chills -- all of which put a good night's sleep further out of reach. "You just can't ever get comfortable. You just constantly feel like you have the flu," she says. It's important that patients talk to their primary care doctor or oncologist about sleep during cancer treatment in part because sleep disorders -- among people with and without cancer -- are treatable, says Cancer Treatment Centers of America's Shamsuddin. In most cases, he says, the approach to treatment is the same. "There are about 70 known sleep disorders out there, and any one of those can obviously affect cancer patients," he says. "Treating them helps to improve [patients'] tolerance to chemotherapy, radiation therapy, as well as their physical, psychological and cognitive functioning." "[Cancer patients] are going through so much, and they're going to be fatigued from the chemotherapy regardless," Shamsuddin says. "But if we can at least avoid them being fatigued from sleep apnea or any other sleep disorder, that's going to affect their quality of life and their energy level and their overall outlook tremendously." US News & World Report