More than 10 million Americans are living with or have survived a diagnosis of cancer. This year, the American Cancer Society estimates 1.4 million new cases will be diagnosed in the U.S.

Cancer patients may experience a variety of problems related to their disease or treatment. One common concern is sleep disturbance. Dave Balachandran, M.D., Sleep Center Director at M.D. Anderson Cancer Center in Houston, says up to 80 percent of cancer patients have some type of sleep problem. According to the National Cancer Institute, about 45 percent of cancer patients experience serious sleep problems (compared to 25 percent in the general population). The most common types of sleep disturbances in cancer patients are insomnia (inability to fall asleep or stay asleep) and disorders of the sleep-wake cycle (disruption in circadian rhythm, or the natural body cycle that regulates wakefulness and sleep). Some patients may also experience sleep apnea or exacerbations of sleep apnea symptoms.

Many factors can trigger sleep problems. Anxiety and depression are common emotions after a cancer diagnosis. Pain, hormonal changes, night sweats, nausea and digestive problems may occur as the consequence of the cancer or as a side effect of cancer treatment. Some patients develop itching, cough, fever, breathing problems or heart-rhythm disturbances. Treatment schedules and hospital stays can also disrupt sleep patterns and lead to fragmented sleep or sleep deprivation.

No matter what the cause, sleep disturbances can take their toll on a cancer patient, leading to fatigue and compounding symptoms of anxiety, depression and irritability. Sleep loss can interfere with memory or the ability to concentrate. In some cases, patients may become so sleep deprived, fatigued or ill they need to discontinue treatment.

Helping the Sleepy Cancer Patient

Balachandran says it's important for cancer patients to get a good night's sleep. M.D. Anderson Cancer Center is the first comprehensive cancer center in the U.S. to open a dedicated sleep center for cancer patients. When a cancer patient is referred to the center, four trained sleep specialists perform a thorough evaluation of the patient, including a physical examination, blood work (if necessary) and a profile of the sleep concerns.

Next the patient goes to the sleep laboratory for overnight assessment of sleep. The sleep specialists monitor stages of sleep, breathing (for signs of sleep apnea) and abnormal behaviors during sleep (like restless legs syndrome). The sleep session is videotaped so the session can be thoroughly reviewed.

Once the patient has been evaluated, doctors make suggestions for better sleep quality. The center even has a Clinical Psychologist who can offer cognitive behavioral training to improve sleep. In some cases, patients may need intervention, like use of C-PAP or surgical intervention for sleep apnea. Balachandran says improved sleep will reduce levels of fatigue and improve quality of life during the day. In addition, better sleep may improve other health problems, like high blood pressure, obesity, diabetes or heart disease, and help the patient tolerate the side effects of cancer or cancer treatment. Balachandran adds, improved sleep may also boost the immune system of cancer patients and help them fight off infections.

For information on the Sleep Center at M.D. Anderson Cancer Center, http://www.mdanderson.org/departments/sleepcenter.

For general information about cancer, or cancer-related sleep problems:

American Cancer Society

National Cancer Institute