Insomnia Research Today is a free monthly online journal that collates and summarizes the latest research about Insomnia, including details on sleep disorders, treatment, medication.

Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program.

Palesh OG, Roscoe JA, Mustian KM, Roth T, Savard J, Ancoli-Israel S, Heckler C, Purnell JQ, Janelsins MC, Morrow GR

Department of Radiation Oncology, Department of Psychiatry, University of Rochester Medical Center, James P. Wilmot Cancer Center, 601 Elmwood Ave, Box 704, Rochester, New York, NY 14642, USA. oxana_palesh@urmc.rochester.edu

PURPOSE: Sleep disruption is prevalent in patients with cancer and survivors, but the prevalence of insomnia, a distressing sleep disorder, in these populations has yet to be determined in large-scale studies. PATIENTS AND METHODS: A total of 823 patients with cancer receiving chemotherapy (mean age, 58 years; 597 female patients) reported on sleep difficulties in a prospective study. RESULTS: During day 7 of cycle 1 of chemotherapy, 36.6% (n = 301) of the patients with cancer reported insomnia symptoms, and 43% (n = 362) met the diagnostic criteria for insomnia syndrome. Patients with cancer younger than 58 years were significantly more likely to experience either symptoms of insomnia or insomnia syndrome (chi(2) = 13.6; P = .0002). Patients with breast cancer had the highest number of overall insomnia complaints. A significant positive association was found between symptoms of insomnia during cycles 1 and 2 of chemotherapy (phi = .62, P < .0001), showing persistence of insomnia during the first two cycles of chemotherapy. Sixty percent of the patient sample reported that their insomnia symptoms remained unchanged from cycle 1 to cycle 2. Those with insomnia complaints had significantly more depression and fatigue than good sleepers (all P < .0001). CONCLUSION: The proportions of patients with cancer in this sample reporting symptoms of insomnia and meeting diagnostic criteria for insomnia syndrome during chemotherapy are approximately three times higher than the proportions reported in the general population. Insomnia complaints persist throughout the second chemotherapy cycle for the majority of patients with cancer in this study. Insomnia is prevalent, underrecognized, undermanaged, and understudied among patients with cancer receiving chemotherapy.

Published 8 January 2010 in J Clin Oncol, 28(2): 292-8.
Full-text of this article is available online (may require subscription).

Articles on Insomnia published 21 December 2009:

Nelotanserin, a novel selective human 5-hydroxytryptamine2A inverse agonist for the treatment of insomnia.   J Pharmacol Exp Ther, 332(1): 281-90.

5-Hydroxytryptamine (5-HT)(2A) receptor inverse agonists are promising therapeutic agents for the treatment of sleep maintenance insomnias. Among these agents is nelotanserin, a potent, selective 5-HT(2A) inverse agonist. Both radioligand binding and functional inositol phosphate accumulation assays suggest that nelotanserin has low nanomolar potency on the 5-HT(2A) receptor with at least 30- and 5000-fold selectivity compared with 5-HT(2C) and 5-HT(2B) receptors, respectively. Nelotanserin ... [Abstract] [Full-text]

Articles on Insomnia published 16 December 2009:

Reduced orbitofrontal and parietal gray matter in chronic insomnia: a voxel-based morphometric study.   Biol Psychiatry, 67(2): 182-5.

BACKGROUND: Brain mechanisms of chronic insomnia, a highly prevalent condition, have barely been investigated. We demonstrate here a decrease in orbitofrontal gray matter (GM) volume that strongly correlates with the severity of complaints. METHODS: In a case-control study, optimized voxel-based morphometry was used to compare the regional brain volumes of 24 medication-free chronic primary insomnia patients (age range 52-74 years, 17 women), carefully selected to exclude psychiatric ... [Abstract] [Full-text]

Articles on Insomnia published 25 November 2009:

Use of a portable biofeedback device to improve insomnia in a combat zone, a case report.   Appl Psychophysiol Biofeedback, 34(4): 319-21.

Insomnia is a common problem in situations of stress. Some forms of stress, however, may contraindicate the use of traditional, pharmacological interventions. Working in a combat zone is such a situation. Alternative means of improving sleep are clearly needed for Service Members. We report a case involving a medical provider who was serving in a military, emergency-services facility in Iraq, and who presented with anxiety, depressed mood, and insomnia. Symptoms were sub-threshold for major ... [Abstract] [Full-text]

Prevalence of insomnia symptoms in sleep laboratory patients with and without sleep apnea.   Psychiatry Res, 170(2): 276-7.

We used the Insomnia Severity Index (ISI) to evaluate the prevalence and distribution of insomnia symptoms in 100 adult patients referred for laboratory evaluation of obstructive sleep apnea (OSA). Sixty-one percent met ISI criteria for a moderate to severe degree of insomnia symptoms. The distribution of insomnia symptoms did not differ by OSA severity. [Abstract] [Full-text]

Articles on Insomnia published 30 October 2009:

Prevalence, natural course, and risk factors of insomnia comorbid with cancer over a 2-month period.   J Clin Oncol, 27(31): 5233-9.

PURPOSE: This study aimed to assess the prevalence, natural course, and risk factors of insomnia comorbid with cancer over a 2-month period. PATIENTS AND METHODS: All patients scheduled to receive a curative surgery for a first diagnosis of nonmetastatic cancer were approached to participate in the study on the day of their preoperative visit. As part of a larger population-based longitudinal study, 991 cancer patients completed various self-report scales and an insomnia diagnostic interview at ... [Abstract] [Full-text]

Articles on Insomnia published 17 September 2009:

Health benefit costs and absenteeism due to insomnia from the employer's perspective: a retrospective, case-control, database study.   J Clin Psychiatry, 70(8): 1098-104.

OBJECTIVE: To objectively assess the economic impact of insomnia on direct medical and prescription costs and indirect absence-related salary replacement costs and on absences and to compare the prevalence and costs of comorbidities in employees with and without insomnia. METHOD: A retrospective analysis was performed on employee data from the Human Capital Management Services Research Reference Database (January 2001-September 2007). Employees were identified as having insomnia (ICD-9 ... [Abstract] [Full-text]

Articles on Insomnia published 3 September 2009:

Characterization of novel selective H1-antihistamines for clinical evaluation in the treatment of insomnia.   J Med Chem, 52(17): 5307-10.

Analogues of the known H(1)-antihistamine R-dimethindene were profiled as potential agents for the treatment of insomnia. Several highly selective compounds were efficacious in rodent sleep models. On the basis of overall profile, indene 1d and benzothiophene 2a had pharmacokinetic properties suitable for evaluation in night time dosing. Compound 2a did not show an in vivo cardiovascular effect from weak hERG channel inhibition. [Abstract] [Full-text]

Articles on Insomnia published 1 September 2009:

Effects of gastroesophageal reflux disease on sleep and outcomes.   Clin Gastroenterol Hepatol, 7(9): 953-9.

BACKGROUND & AIMS: Nighttime symptoms of gastroesophageal reflux disease (GERD) are prevalent and have negative effects on sleep quality. We quantified the effects of GERD symptoms on sleep difficulties and their effects on outcomes. METHODS: Data were obtained from a patient-reported survey conducted in 2006 among the general US population. Respondents who had experienced GERD symptoms at least twice during the past month were categorized as GERD patients and were subclassified into groups ... [Abstract] [Full-text]

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