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Evaluation and Management of Sleep and Circadian Rhythm Disturbance in Cancer

  • Palliative and Supportive Care (MP Davis, Section Editor)
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Opinion statement

Sleep and circadian rhythm disturbance are among the most commonly experienced symptoms in patients with cancer. These disturbances occur throughout the spectrum of cancer care from diagnosis, treatment, and long into survivorship. The pathogenesis of these symptoms and disturbances is based on common inflammatory pathways related to cancer and its’ treatments. The evaluation of sleep and circadian disorders requires an understanding of how these symptoms cluster with other cancer-related symptoms and potentiate each other. A thorough evaluation of these symptoms and disorders utilizing validated diagnostic tools, directed review of clinical information, and diagnostic testing is recommended. Treatment of sleep and circadian disturbance in cancer patients should be based on the findings of a detailed evaluation, including specific treatment of primary sleep and circadian disorders, and utilize integrative and personalised management of cancer-related symptoms through multiple pharmacologic and non-pharmacologic modalities. Recognition, evaluation, and treatment of sleep and circadian rhythm disturbance in cancer may lead to improved symptom management, quality of life, and outcomes.

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Authors and Affiliations

  1. Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street. Unit 1462, Houston, TX, 77030-4009, USA

    Diwakar D. Balachandran MD & Saadia A. Faiz MD

  2. Division of Health Sciences (Mental Health & Wellbeing), University of Warwick, Warwick Medical School, Gibbet Hill, Coventry, UK

    Michelle A. Miller BSc, PhD, MACadMEd

  3. Department of Palliative, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Sriram Yennurajalingam MD

  4. North Wales Cancer Treatment Centre, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK

    Pasquale F. Innominato MD, PhD

  5. Cancer Chronotherapy Team, Warwick Medical School, Coventry, UK

    Pasquale F. Innominato MD, PhD

Authors
  1. Diwakar D. Balachandran MD
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  2. Michelle A. Miller BSc, PhD, MACadMEd
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  3. Saadia A. Faiz MD
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  4. Sriram Yennurajalingam MD
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  5. Pasquale F. Innominato MD, PhD
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Correspondence to Diwakar D. Balachandran MD.

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Diwakar D. Balachandran declares that he has no conflict of interest. Michelle A. Miller declares that she has no conflict of interest. Saadia A. Faiz declares that she has no conflict of interest. Sriram Yennurajalingam declares that he has no conflict of interest. Pasquale F. Innominato has received an institutional grant from Philips Respironics for an independent study.

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Balachandran, D.D., Miller, M.A., Faiz, S.A. et al. Evaluation and Management of Sleep and Circadian Rhythm Disturbance in Cancer. Curr. Treat. Options in Oncol. 22, 81 (2021). https://doi.org/10.1007/s11864-021-00872-x

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