Evaluation and Management of Sleep and Circadian Rhythm Disturbance in Cancer

• Published in: Current treatment options in oncology Vol. 22; no. 9; p. 81
• Main Authors: Balachandran, Diwakar D., Miller, Michelle A., Faiz, Saadia A., Yennurajalingam, Sriram, Innominato, Pasquale F.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-09-2021; Springer Nature B.V
• Subjects: Algorithms; Biomarkers; Cancer; Circadian rhythm; Circadian rhythms; Clinical Decision-Making; Combined Modality Therapy; Diagnosis, Differential; Disease Management; Disease Susceptibility; Humans; Inflammation; Medicine; Medicine & Public Health; Neoplasms - complications; Oncology; Palliative and Supportive Care (MP Davis; Patients; Quality of life; Section Editor; Sleep; Sleep Disorders, Circadian Rhythm - diagnosis; Sleep Disorders, Circadian Rhythm - etiology; Sleep Disorders, Circadian Rhythm - therapy; Survival; Symptom Assessment; Symptom management; Topical Collection on Palliative and Supportive Care; Treatment Outcome; Clinical algorithm; Sleep; Treatment; Circadian; Symptoms; Cancer
• ISSN: 1527-2729; 1534-6277; 1534-5277
• DOI: 10.1007/s11864-021-00872-x

Opinion statement
Sleep and circadian rhythm disturbance are among the most commonly experienced symptoms in patients with cancer. These disturbances occur throughout the spectrum of cancer care from diagnosis, treatment, and long into survivorship. The pathogenesis of these symptoms and disturbances is based on common inflammatory pathways related to cancer and its’ treatments. The evaluation of sleep and circadian disorders requires an understanding of how these symptoms cluster with other cancer-related symptoms and potentiate each other. A thorough evaluation of these symptoms and disorders utilizing validated diagnostic tools, directed review of clinical information, and diagnostic testing is recommended. Treatment of sleep and circadian disturbance in cancer patients should be based on the findings of a detailed evaluation, including specific treatment of primary sleep and circadian disorders, and utilize integrative and personalised management of cancer-related symptoms through multiple pharmacologic and non-pharmacologic modalities. Recognition, evaluation, and treatment of sleep and circadian rhythm disturbance in cancer may lead to improved symptom management, quality of life, and outcomes.