Tuesday, July 1, 2014

Sleep and Cancer - It Matters

Carolina Salvador M.D., UAB Division of Hematology and Oncology. Dr. Salvador’s research interests include preventative medicine, integrative medicine and minority health-related issues. Dr. Salvador answered our questions related to the critical importance of sleep for good health below.

Q: Do cancer patients have specific issues regarding sleep?
Dr. Salvador: Patients suffering from cancer have more problems with lack or poor quality of sleep than people without cancer. Fifty percent of cancer patients suffer from sleep disorders compared to 15 percent in the people without cancer. Insomnia (lack of sleep) can present as difficulty falling asleep, waking up several times during the night, or waking up early with being able to go back to sleep. For cancer patients, certain medications, hospitalization, chemo, radiation, or hormonal therapy, pain, hot flashes, nausea and vomiting as well and anxiety and depression can keep them from getting much needed sleep.
Q: Is there a certain number of hours cancer patients should sleep?
Dr. Salvador: For a healthy patient, 6 to 8 hours of sleep would suffice. A person with cancer would need to sleep at least as much, taking into account how much they slept before the diagnosis as well as their age. However, if a person feels they are sleeping too much, mentioning it to your doctor is a good idea.
Q: What about cancer survivors? Will their body ever return to “normal” or will their bodies demand more sleep than average?
Dr. Salvador: Some survivors continue to have sleep problems and we don’t understand why. And, though there is evidence that suggests that a good sleep routine may increase survival, researchers are still trying to understand this relationship and what is normal.
Q: What should someone do if they have trouble staying asleep or cannot stay asleep?
Dr. Salvador: There are some simple, basic things to try to improve the sleep. The first thing they should do is address the problem with their physician/oncologist who can prescribe the treatments that may work best. They can also refer the patient to a psychologist, an integrative oncologist, or physical therapy.
Q: How does sleep play in to stress?
Dr. Salvador: Stress usually causes a person to lose sleep. The less sleep, the more fatigue; the more fatigue the less ability to cope with stress. So, this ends up being a cycle that’s difficult to treat unless caught in time. A cancer patient needs to make their oncologist aware of stress and how is it is affecting his/her quality of life. Then the oncologist can refer them to get the care they need.
Q: Do cancer patients tend to need more sleep than non-cancer patients?
Dr. Salvador: Everyone needs sleep to maintain a normal balance, but cancer patients need sleep more to help their bodies fight the cancer and deal with the added stress of the disease and the treatment. Sleep allows the body to restore its energy, repair damaged tissues and keep the immune system balanced. Thus, with a lack of sleep, fatigue sets in, the immune system becomes more vulnerable and activities become more difficult. It also increases the risk of depression. Therefore, good sleep habits help the body recover from illnesses as well as from cancer and its treatment.
How to get a good night’s sleep:
            Limit or discontinue caffeine, nicotine, and alcohol.
            Daytime naps should only be 15-20 minutes.
            Avoid activities in the evening (such as exercise, stressful movie, computers, etc.) that can stimulate you. Instead use restful music, reading or relaxation techniques in the evening hours.
            Follow a sleep routine. Go to bed and get up around the same time.
            If you can’t fall asleep within 20 minutes, get up and try another form of relaxation.
            Do not use the bed to read or watch TV. Train your body to know that your bed is for rest.
            ry complementary therapy approaches like mindfulness meditation, yoga, guided imagery/hypnosis, muscle relaxation exercises.
            Some herbs and supplements can be helpful. However, consult an integrative medicine oncologist who can recommend those that will work best for you without interfering with your treatment. He or she can also help you understand the correct doses.

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