Treating sleep problems may improve pain management in patients with cancer

Westchester, Ill. –A study in the April 15 issue of the Journal of Clinical Sleep Medicine suggests that sleep problems lead to increased pain and fatigue in cancer patients. The results indicate that interventions aimed at trouble sleeping would be expected to improve both pain and fatigue in this patient population.

Results show that more than half the sample reported having trouble sleeping, with 26 percent reporting moderate or severe trouble sleeping. Compared with patients who reported no trouble sleeping, patients with moderate to severe trouble sleeping reported significantly more fatigue, pain and depressed mood. Using structural equation modeling analysis to evaluate causal relations and directions of effect, the best-fitting model indicates that trouble sleeping led to increased ratings of pain.

According to the authors, the relationship between pain and sleep often has been assumed to be reciprocal. In the present study, however, a model of reciprocal causation could not be fit to the data, and models in which pain caused trouble sleeping did not fit as well as the model in which trouble sleeping caused pain.

“We believed we would find a bi-directional relationship between insomnia and pain, but instead found that trouble sleeping was more likely a cause, rather than a consequence, of pain in patients with cancer,” said lead author Edward J. Stepanski, chief operational officer at the Accelerated Community Oncology Research Network in Memphis, Tenn.

The study included demographic, clinical and patient-reported outcomes data from 11,445 cancer patients undergoing treatment at the West Clinic, a large community oncology practice in Memphis. Participants had an average age of 61.5 years, and 74 percent were female. Breast cancer was the most common form of cancer, and about 25 percent of study subjects had received chemotherapy in the last 30 days. Increases in depressed mood also led to increased ratings of pain.

Younger age and recent administration of chemotherapy were both associated with increased trouble sleeping. According to the authors, younger patients often receive more aggressive chemotherapy than older patients; therefore, younger patients may be exposed to more treatment-related toxicity.

Stepanski stated that several studies have shown that cognitive behavioral therapy (CBT) improves sleep in cancer patients who have insomnia. He believes that this type of intervention may decrease patients’ pain and fatigue by improving their sleep.

More information is available from the AASM about sleep and breast cancer at http://www.sleepeducation.com/Article.aspx?id=1076 and about cognitive behavioral therapy at http://www.sleepeducation.com/Treatment.aspx?id=5.

The Journal of Clinical Sleep Medicine (JCSM) contains published papers related to the clinical practice of sleep medicine, including original manuscripts such as clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the JCSM publishes proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine

For a copy of the study, “The Relation of Trouble Sleeping, Depressed Mood, Pain, and Fatigue in Patients with Cancer,” or to arrange an interview with an AASM spokesperson, please contact Kelly Wagner, AASM public relations coordinator, at (708) 492-0930, ext. 9331, or kwagner@aasmnet.org.

AASM is a professional membership organization dedicated to the advancement of sleep medicine and sleep-related research. As the national accrediting body for sleep disorders centers and laboratories for sleep related breathing disorders, the AASM promotes the highest standards of patient care. The organization serves its members and advances the field of sleep health care by setting the clinical standards for the field of sleep medicine, advocating for recognition, diagnosis and treatment of sleep disorders, educating professionals dedicated to providing optimal sleep health care and fostering the development and application of scientific knowledge.

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By : KASMIAH MUSTAPHA

2009/03/23

Most of us would have experienced an inability to sleep at some point in our lives. KASMIAH MUSTAPHA talks to an expert to find out the causes.

IT’S 3am and Adam has been tossing and turning throughout the night. He has been trying hard to go to sleep but can’t seem to do it. Even if he does fall asleep, he will be awake 10 minutes later.

Adam has been suffering from this sleeping disorder for months. Insomnia is the most common sleeping disorder; most of us would have faced this problem at some point of our lives.

Some people only suffer from it for a short term and will be back to normal in no time, while others require professional help.

Symptoms include difficulty in falling asleep, waking up often during the night and having trouble going back to sleep, waking up too early in the morning and feeling tired upon waking.
Research has found that insomnia is a persistent condition for many people. About 75 per cent of those with insomnia experience the condition for at least a year, and almost half experience it for three years.

Darul Ehsan Medical Centre consultant physician and cardiologist Col (R) Dr Abd Rahman Mohd Ali said when insomnia leads to problems such as lethargy, fatigue, inability to concentrate and low quality of life, one has to seek treatment.

“For some people, worrying about their health, financial situation and work can result in them not being able to sleep for days, weeks or even months. Once they are deprived of sleep, they may face other problems.

“In Adam’s case, a family member had died of cancer. He began to worry that he too had cancer. Even a slight pain had him rushing to the doctor as he was convinced that he will die of cancer. The worry, stress and fear kept him awake.”

Dr Abd Rahman said disturbed sleeping patterns can also lead to insomnia.

“If the time you go to sleep is constantly changed, the body will find it difficult to adjust after a while and you will start having sleepless nights.

“We need to maintain a regular bedtime. If you usually go to sleep at 11pm and wake up at 6am, you need to keep to it. You shouldn’t sleep late or wake up late because your biological clock has been set. If you sleep late, you tend to oversleep, and this pattern can go on for days.”

A recent study in the United States found that almost a third of all Americans suffer from insomnia because they are worried about the economy, their jobs or finances.

The study also found that those whose sleep is affected are less likely to work efficiently, exercise and eat healthily.

In the study, 27 per cent of those surveyed said they had disturbed sleep in the past month due to money issues — including personal finances (16 per cent), the economy (15 per cent) or losing their jobs (10 per cent).

The study also revealed that insomnia is more common among females, especially menopausal women, due to hormonal changes.

People with a medical condition will also face difficulty in sleeping. Those who are suffering from asthma, diabetes, prostate problems, arthritis, depression and anxiety are prone to insomnia.

Dr Abd Rahman said if a person is sleep deprived, it will affect his concentration and work which, in turn, will have consequences on his social and economic life. Lack of sleep will also increase certain conditions such as hypertension, diabetes, stress, heart disease, headache and depression.

The treatment for insomnia usually begins with changing one’s lifestyle and behaviour. In many cases, doctors would not prescribe medication for treating it as it can lead to addiction, said Dr Abd Rahman.

“People who suffer from insomnia must maintain good hygiene and good sleeping habits including maintaining a conducive environment in their bedroom.

“Make sure your bedroom is purely for sleeping. For some people, their bedrooms also double up as their office with laptops, TV sets and such.”

There are also those who are not opposed to eating in bed. They make the bedrooms not conducive to a good night’s sleep.

Another no-no is taking long naps during the day.

“If you feel sleepy, take a short nap between 10 and 15 minutes after lunch. Do light exercises at least four hours before you go to bed and try not to have a heavy meal close to your bedtime.”

Caffeine, nicotine and alcohol should be avoided late in the day. Caffeine and nicotine are stimulants which will keep us from falling asleep while alcohol can cause waking in the night and interferes with sleep quality.

If you are not sleepy, have a warm bath or drink that will help you relax or read a book that you know will help you fall asleep.

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Insomnia (sleeplessness) is a common sleep disorder in which a person experience difficulty in sleeping. Depression and anxiety are the two main causes of insomnia. Poor concentration, short memory, decreased alertness and mental sluggishness are major symptoms of sleeplessness. Person suffering from insomnia feel irritability without any obvious cause.

Home Remedies to Treat Insomnia

1.Take your dinner at least 4 hours ahead of your bed time. Insomnia is often aggravated by digestive problems, and hence, it is best to avoid the problem altogether.

2.Avoid drink such as coffee, alcohol, and tea that influences sleep. In case you must have your regular cup of coffee, at least ensure that you take it before a minimum of four hours from your bedtime.

3.Regular exercise helps in relieving stress, depression, anxiety and sleeplessness. Even a walk for about 30 minutes daily is also good. Try to gradually increase it to one hour or so for best results.

4.If you find that you cannot sleep, do something that you enjoy (reading, listing to music, writing letters to dear ones, etc) aiming to relax your mind and body. Sleep usually comes after your body relaxes completely.

5.Self help and natural therapies also help in treating insomnia. Improve sleep habits and environment. Practice stress management and relaxation techniques. Acupuncture and massage, cognitive behavior therapy, herbal remedies and homeopathic remedies are also helpful in treating this disorder.

6.Aromatherapy is another useful natural treatment for sleeplessness. Taking a bath before going to bed using a few drops of essential oils like lavender, marjoram, or ylang-ylang can help. Or you can drop these oils directly on your pillow.

7.Diet containing magnesium can help to improve sleep in those suffering from sleeplessness. So, include magnesium rich foods in your diet.

Disclaimer: This article is not meant to provide health advice and is for general information only. Always seek the insights of a qualified health professional before embarking on any health program.

Copyright Nick Mutt, All Rights Reserved. If you want to use this article on your website or in your ezine, make all the urls (links) active.

By: Nick Mutt

Article Directory: http://www.articledashboard.com

Here is an excellent Anti stress herbal supplement that will give you stress free life you were longing for. Also read Home remedies for insomnia at Natural cures website – a health guide to make you and your family fit and healthy.

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Until last year I would have done almost anything to solve my sleep problems. For most of my life I had been “one of those people” cursed with insomnia and troubled sleep. I have had sleep problems for about twenty years and needless to say it has affected my whole life. It would take me hours to fall asleep. I would awaken repeatedly every night, and then struggle to get back to sleep: my mind would start its merry-go-round and go on without respite until dawn.

I have discovered an amazing Brain Technology,(The Sleeptracks Sleep Optimization Program) that Will Make You… “Fall Asleep in Minutes Instead of Hours, Sleep Soundly Through the Night and Wake Up Rested — Without Resorting to Sleeping Drugs… Guaranteed!”

I now sleep less than before (6-7 hours per night) but I feel more rested. And I gradually uncovered extremely surprising and little-known facts about sleep and how the brain works during sleep. Instead of taking hours to fall asleep, I’m off in less than 10 minutes. I literally sleep like a baby and never wake up during the night anymore. Did you know that your sleep is divided into cycles of approximately 90 minutes. Each night, you go into the different phases of sleep several times: going from light sleep to deep sleep, then light sleep again, after which you normally have a period of dreaming.

Now, here’s the good news: studies and tests done by sleep researchers have showed that the capacity to fall asleep, then enter and stay in a deep sleep is a skill. You should also know that one very important thing is most likely missing in your brain if you suffer from troubled sleep. I’m talking about a form of brain activity that is in sorely low supply in people who sleep badly (and, incidentally, in people who suffer from ADHD). Its purpose is not to put you to sleep (even though it might make you drowsy), but to re-train your brain’s activity during the day so you’ll sleep soundly at night.

Scientists think those brainwaves are involved in the control of arousal states, energy levels, and also of inhibiting movement during sleep. It will naturally and easily increase brain activity and condition your brain to sink into the deep sleep you need most. The Fall Asleep Track has been designed to lead you progressively into slower and slower brainwaves, making you sink deeper and deeper.

For Instance,using an EEG machine, sleep researchers can tell precisely when someone is sleeping lightly, then deeply, and when he’s dreaming. The lines at the top represent very high-frequency waves (showing mental activity), and the ones at the bottom represents slow-frequency wave activity (more pronounced during sleep and deep meditative states). The Sleep Tracks (contained in THe Sleep Optimization Program) are designed to influence the electrical activity going on in your brain in the form of brainwaves. The Sleep Tracks work the exact same way to gently guide your brain into producing more of certain types of brainwaves and less of others. You just listen and let your brain ride the Sleep Tracks wave. This is why carefully crafted brainwave entrainment sessions can have a lasting effect on your sleep. What that means for you is that you won’t have to listen to the Sleep Tracks forever to benefit from them.

You should know it by now: “TRYING” to sleep is a recipe for disaster. Sleep specialists agree: a combination of brain training and effective sleep strategies is the best and most direct way to combat insomnia. Even better, you can put them to the test completely risk-free, because “The Sleeptracks Sleep Optimization Program” effectiveness is 100% guaranteed. If you’re not especially anxious or tense, but can’t get to sleep because your mind is producing non-stop chatter, this program is for you. Listen to the sessions and let yourself be guided gently from being awake to drowsy to profoundly asleep in minutes instead of hours. I must say that my sleep has improved a lot because I am now entering a deeper level of sleep. Sleep problems are a thing of the past for me now.

Article Written By J. Foley

http://offto.net/fallasleep/

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