Sleep Problems Impair Childhood Cancer Survivors

CURE, Fall 2011, Volume 10, Issue 3

Study shows adult survivors of childhood cancer may have sleep issues that negatively affect cognitive function.

Everyone’s heard the saying, “An apple a day keeps the doctor away.” While this accepted adage takes care of one medical need, new evidence suggests shifting the attention from apples to Zs.

According to a recent study led by investigators at St. Jude Children’s Research Hospital in Memphis, adult survivors of childhood cancer who experience fatigue or trouble sleeping are three to four times more likely to encounter cognitive impairments, such as difficulty with attention, memory and the speed at which they process information, than survivors without sleep problems. These impairments can negatively affect survivors’ abilities to maintain a steady job, further their education or even their capability to live alone.

Survivors of central nervous system tumors were found to have the highest rates of cognitive impairment. Also, adult survivors on antidepressants had higher risk of memory problems and higher risk of impaired task efficiency.

Long-term childhood cancer survivors are already more susceptible to impaired neurocognitive functions due to a direct or indirect result of treatment to their central nervous systems, but this study, published online in the April 11 edition of Cancer, was the first to illustrate that difficulties sleeping could be associated with these problems. The investigators reached this conclusion by examining neurocognitive questionnaires filled out by 1,426 childhood cancer survivors and comparing the results to 384 healthy sibling controls.

This study also raises the possibility that the many psychological effects of cancer and cancer therapies are actually responsible for sleep disorders. Nevertheless, it supports further study of the beneficial effects of improving ones sleep habits, which even with this uncertainty, represents a sound prescription.

Although current treatment options leave future survivors vulnerable to similar cognitive issues, Kevin Krull, PhD, corresponding author and associate member of the St. Jude department of epidemiology and cancer control, says the team is hoping to improve survivors’ outcomes without altering successful treatment methods by focusing on sleep hygiene.

“They need to pay better attention to their sleep quality,” says Krull. “Take the time to get a good night’s sleep. In our society, that’s not always an easy thing to do. [But] if you’re at risk for some of these cognitive problems, it’s all the more important.” Need some help getting a good night’s sleep?

If you find that it takes you longer than 30 minutes to fall asleep at night, Krull suggests:

1. Exercise during the day rather than before bed.

2. Make your bedroom more inviting by keeping it dark and cool.

3. Do not read or watch TV in bed.

4. Wake up at the same time every day regardless of whether it’s a weekday or weekend.