Proposal for Managing Cancer-Related Insomnia: A Systematic Literature Review of Associated Factors and a Narrative Review of Treatment

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2024-11-25 DOI:10.1002/cam4.70365

Yoshinori Saeki, Yukiyoshi Sumi, Yukinori Ozaki, Mari Hosonaga, Yoshiyuki Kenmotsu, Takuma Onoe, Ken Yamaguchi, Yoshihisa Matsumoto

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Abstract

Objective

Insomnia is common in patients with cancer. It has a multifactorial etiology that may include the disease process, adverse effects of anticancer therapies, and/or an association with other comorbidities. The purpose of this review was to identify risk factors for insomnia and suggest optimal management strategies.

Methods

We conducted a systematic literature review to elucidate the risk factors for insomnia and sleep disturbances in patients with solid tumors. The effects of sleep medications in this population were also described.

Results

A total of 75 publications were evaluated, including those on breast, lung, gynecologic, brain, head and neck, gastrointestinal, prostate, thyroid, and mixed cancers. We classified the factors related to insomnia or sleep disturbance in cancer into four categories: (1) patient demographic characteristics (e.g., age, marital or socioeconomic status); (2) mental state (e.g., depression or anxiety); (3) physical state (e.g., fatigue, pain, or restless legs syndrome); and (4) anticancer treatment-related (e.g., use of chemotherapy, opioids, or hormone therapy). Overall, literature on the pharmacologic treatment of insomnia is extremely limited, although some efficacy data for zolpidem and melatonin have been reported.

Conclusions

Demographic characteristics, physical and mental distress, and anticancer treatments are all risks for insomnia in patients with cancer. The limited evidence base for pharmacologic therapy in this patient population means that healthcare professionals need to implement a comprehensive and multidisciplinary pathway from screening to management.

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管理癌症相关失眠症的建议：相关因素的系统文献综述和治疗方法的叙述性综述

失眠是癌症患者的常见病。其病因是多因素的，可能包括疾病过程、抗癌疗法的不良反应和/或与其他合并症有关。本综述旨在确定失眠的风险因素，并提出最佳管理策略。方法我们进行了一项系统性文献综述，以阐明实体瘤患者失眠和睡眠障碍的风险因素。此外，还介绍了睡眠药物对这一人群的影响。结果我们共评估了 75 篇文献，包括有关乳腺癌、肺癌、妇科癌、脑癌、头颈癌、胃肠癌、前列腺癌、甲状腺癌和混合型癌症的文献。我们将癌症患者失眠或睡眠障碍的相关因素分为四类：(1) 患者人口统计学特征（如年龄、婚姻或社会经济状况）；(2) 精神状态（如抑郁或焦虑）；(3) 身体状况（如疲劳、疼痛或不安腿综合征）；(4) 抗癌治疗相关因素（如使用化疗、阿片类药物或激素治疗）。总体而言，有关失眠症药物治疗的文献极为有限，但有报道称唑吡坦和褪黑素具有一定疗效。结论人口统计学特征、身体和精神痛苦以及抗癌治疗都是导致癌症患者失眠的风险因素。对这一患者群体进行药物治疗的证据基础有限，这意味着医护人员需要实施从筛查到管理的综合、多学科路径。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.