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Half of people with cancer sleep badly, so sleep and body-clock interventions matter. Talking therapy for insomnia works well and is under-used; whether fixing sleep or body-clock disruption changes the cancer itself is unproven.
Insomnia affects 30-60% of cancer patients and survivors and worsens fatigue, pain, depression and cognition. Cognitive behavioural therapy for insomnia (CBT-I), including digital versions, has strong randomised evidence in cancer survivors and is first-line in guidelines; hypnotics are second-line and mindfulness, acupuncture and exercise have moderate evidence. Night-shift work involving circadian disruption is 'probably carcinogenic' (IARC Group 2A, 2019) on breast, prostate and colorectal cancer evidence. Disrupted rest-activity rhythms measured by actigraphy predict shorter survival in metastatic colorectal and breast cancer, and morning versus afternoon dosing of checkpoint inhibitors has been associated with better outcomes in retrospective cohorts, prompting randomised chronotherapy trials. Melatonin, widely marketed, has inconsistent evidence for sleep in cancer and none for anticancer effect at physiological doses. The disease-modifying claims for sleep and circadian interventions therefore remain hypotheses; the symptom benefit is real.
Restoring consolidated sleep and robust circadian rhythms normalises cortisol and melatonin secretion, immune cell trafficking and cell-cycle gene expression, and improves tolerance of and possibly response to time-sensitive therapies.
Query for this technology: (TITLE:"Sleep and circadian interventions in cancer" OR ABSTRACT:"Sleep and circadian interventions in cancer") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Sleep and circadian interventions in cancer, not a curated reading list.
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Shares Mindfulness-based stress reduction and cognitive therapy, Cognitive behavioural therapy for insomnia (CBT-I), Survivorship care and late-effects surveillance, Survivorship and late effects are neglected.
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Shares Mindfulness-based stress reduction and cognitive therapy, Cognitive behavioural therapy for insomnia (CBT-I), Survivorship care and late-effects surveillance, Survivorship and late effects are neglected.
Shares What actually works after treatment, Survivorship care and late-effects surveillance, Survivorship and late effects are neglected, HR-positive / HER2-negative breast cancer.