Can’t Sleep? You’re Not Alone

• Most adults need about seven to nine hours of sleep every night. But, about 15 to 20 percent of adults in the U.S. have a sleep disorder, and 30 percent have had insomnia at some point.

  Anyone who has missed a night’s sleep knows what it’s like. Lack of sleep causes irritability, fatigue, an inability to concentrate, and can impact physical health.

  Cancer patients and survivors are no exception. Cancer-related stress, discomfort, treatment side effects, and other factors can make sleep elusive for some, while others have trouble getting out of bed.

  Alan Haber, MD, FCCP, the Chief of the Division of Pulmonary, Sleep and Critical Care Medicine at Fox Chase Cancer Center, spoke about the connection between disturbed sleep and cancer treatment.

  What Causes Sleep Problems?

  “Insomnia is the most common sleep disorder, and at least half of patients with certain malignancies experience it at some point. Pain, nighttime reflux, leg movements, depression and other psychiatric conditions can contribute to sleeplessness,” Haber said.

  Excessive sleepiness is another common issue. “In the general population, this most often occurs when people don’t have time to get enough sleep. In the context of cancer, we see many people who suffer from poor sleep quality due to sleep apnea or when head and neck cancer treatment affects functionality or airway size,” Haber said.

  “We also have patients with an increased need for sleep due to cancer fatigue, treatment-related pain, anxiety, and psychiatric conditions,” he added.

  Sleep disorders can be related to what Haber refers to as “The Three P’s”:

  • Predisposition (depression, family history)
  • Precipitating event (cancer, death in the family)
  • Perpetuating behavior (drinking coffee to stay awake, using alcohol to induce sleep, becoming anxious about sleep)

  What approach do doctors at Fox Chase take to resolve patient’s sleep problems?

  The Division of Pulmonary, Sleep and Critical Care Medicine at Fox Chase Cancer Center recognizes the complex interaction between sleep disorders and cancer, and provides a broad range of services for patients with sleep disorders. 

  “Our patients have many reasons for disturbed sleep, and it can contribute to poor quality of life. We also know that there are potential connections between sleep apnea, cancer, and mortality. This is why we have such a large incentive to address sleep issues,” Haber said.

  Sleep issues affect many people but tend to be under-reported by patients and under-recognized by physicians. Patients may not think sleep issues are worthy of discussion with their physicians, and doctors may be reluctant to prescribe medications for sleep.

  That’s why there is a push in the cancer community to ask patients about sleep and fatigue.

  “When a patient comes to us with insomnia we focus on understanding the underlying mechanism so that we can intervene. There are treatments for poorly controlled pain, nighttime reflux and restless leg movements,” Haber said.

  Sleep Solutions

  • Sleep studies can offer valuable information about why a patient may not be getting restful sleep. Patients diagnosed with specific breathing disorders such as sleep apnea can obtain appropriate equipment and support.
  • Interventional pulmonologists address lung-related complications and pulmonological issues that can affect sleep.
  • Cognitive behavioral therapy provides practical recommendations and techniques to promote uninterrupted sleep.

  “We care for patients with cancer-related sleep issues, and for patients with sleep and pulmonologic issues not linked to cancer,” Haber said.

  How can patients get help?

  Fox Chase takes sleep issues seriously. Sleep clinic nurses provide up-to-date guidance on sleep equipment and track patient progress.

  The sleep disorders clinic at Fox Chase is accredited by the American Academy of Sleep Medicine and is equipped to perform both overnight and home sleep studies to evaluate for sleep apnea, insomnia, and other sleep-related disorders.

  “We provide a seamless transition from cancer care to sleep issues. Current patients and survivors can seek help without leaving the Fox Chase system.” Haber said. “My colleagues in sleep and pulmonary medicine and psychiatry are ready to address sleep issues driven by breathing and psychological concerns.”

  Learn more about treatment of sleep disorders at Fox Chase Cancer Center.