Insomnia in the context of cancer: A review of a neglected problem

This article reviews the evidence on the diagnosis, epidemiology, etiology, and treatment of insomnia in the context of cancer and proposes several ar eas for future research. Clinical and diagnostic features of insomnia are d escribed and prevalence estimates of insomnia complaints in cancer patients are summarized. Then, potential etiologic factors (ie, predisposing, preci pitating, and perpetuating factors) and consequences of insomnia (ie, psych ologic, behavioral, and health impact) in the concert of cancer are discuss ed. Finally, pharmacologic and psychologic treatments previously shown effe ctive to treat insomnia in healthy individuals are discussed as valuable tr eatment options for cancer patients as well. because long-term use of hypno tic medications is associated with some risks (eg, dependence), it is argue d that psychologic interventions (eg, stimulus control, sleep restriction, cognitive therapy) are the treatment of choice for sleep disturbances in th e context of cancer, especially when it has reached a chronic course. Howev er, the efficacy of these treatments has yet to be verified specifically in cancer patients. (C) 2001 by American Society of Clinical Oncology.