Excessive daytime sleepiness in cancer patients
- PDF / 221,445 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 3 Downloads / 186 Views
PSYCHIATRICS • SHORT COMMUNICATION
Excessive daytime sleepiness in cancer patients Bibi Aneesah Jaumally 1 & Aneesa Das 2 & Nathaniel C. Cassell 1 & G. Nancy Pachecho 3 & Ruckshanda Majid 1 & Lara Bashoura 3 & Diwakar D. Balachandran 3 & Saadia A. Faiz 3 Received: 26 May 2020 / Revised: 15 July 2020 / Accepted: 17 July 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose Excessive daytime sleepiness (EDS) is commonly reported in patients with cancer, and it is also a cardinal feature of central disorders of hypersomnolence. Multiple sleep latency testing (MSLT) is used for objective assessment. Methods A retrospective review of patients with cancer history who underwent formal sleep evaluation and MSLT from 2006 to 2019 was performed. Clinical characteristics, sleep-related history, and polysomnographic data were reviewed. Results Of 16 patients with cancer history, 9 were women (56%) and median age was 49. Cancer diagnoses included 4 central nervous system, 3 breast, 1 lymphoma, and 9 other solid malignancies, and 31% were undergoing active treatment. Comorbid conditions included depression, obstructive sleep apnea, and cancer-related fatigue. Daytime fatigue (94%), daily naps (81%), and EDS (69%) were the most common symptoms. Hypnopompic and hypnogogic hallucinations, sleep paralysis, sleep attacks, and cataplexy were present in a few. Epworth Sleepiness Scale scores were consistent with EDS in 88%, and mean sleep latency was less than 8 min in 69%. Only 31% had more than 2 sleep-onset REM periods. MSLT supported diagnoses of central disorders of hypersomnolence in 5 patients (4 narcolepsy, 1 idiopathic hypersomnia); 5 hypersomnia due to a medical disorder, psychiatric condition, or medication; and 6 with normal results. Pharmacotherapy was prescribed in 5 patients. Conclusions EDS in patients with cancer may be multifactorial, but persistent symptoms may indicate an underlying disorder of hypersomnolence. Sleep referral and polysomnography to exclude other sleep disorders may be indicated. MSLT can help confirm the diagnosis. In those with normal MSLT, further evaluation for mood disorder should be considered. Keywords Sleep disorder . Hypersomnia . Cancer . MSLT . Excessive daytime sleepiness . Disorder of hypersomnolence
Introduction Fatigue, insomnia, and excessive daytime sleepiness (EDS) are commonly reported in cancer patients, and certain cancer diagnoses may be prone to underlying sleep disorders [1]. EDS is a prominent symptom among patients with primary brain tumors especially in those undergoing cranial radiation [2, 3]. Several case reports and small case series have also described a central disorders of hypersomnolence associated * Saadia A. Faiz [email protected]
with brain tumors [4–6]. Reports on central disorders of hypersomnolence in other cancer patients are sparse. In cancer patients, there are many potential etiologies for EDS including side effects from anti-neoplastic therapy, disruption of normal sleep-wake cycles, advanced cancer, and disease progression [7]. EDS is also
Data Loading...
