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SLEEP PATTERNS & FATIGUE IN BREAST CANCER PATIENTS THE FOCUS OF MOORES UCSD CANCER CENTER STUDY 
Week of April 1-5 is National Cancer Fatigue Awareness Week

Women fighting the battle against breast cancer face an array of emotional and physical challenges that require as much energy as they can gather.  Unfortunately, poor sleep and increased fatigue are two of the chief complaints of women diagnosed with breast cancer, which can negatively impact their treatment and quality of life.

Researchers at the Rebecca and John Moores UCSD Cancer Center* are conducting a study to determine the connection between sleep and fatigue in women with breast cancer. The four-year study, funded by a $225,000 per year grant from the National Cancer Institute, will monitor the sleep rhythms of 100 women from the time they are diagnosed with breast cancer through their chemotherapy treatment.   

While there is no medically standard definition of cancer-related fatigue, it is generally regarded as a form of tiredness that does not improve following rest or sleep. In addition to disrupted nighttime sleep, breast cancer patients often report tiredness, weakness, lack of energy, difficulty concentrating and sleepiness. Cancer Center researchers believe that some degree of cancer-related fatigue experienced during the day may be related to sleep/wake cycles or the quantity and quality of sleep obtained at night.

"The sleep rhythm is an important biological cycle that, if changed, can have profound effects on physical well-being," said the study's principal investigator, Sonia Ancoli-Israel, Ph.D, a researcher in the Cancer Center’s Cancer Symptom Control Program. "We know that several factors may contribute to patients’ disrupted sleep, including pain, depression and chemotherapy. What we don’t know is the role an individual’s sleep rhythm plays in offsetting the disruptions.  Once we determine how sleep, fatigue and breast cancer are related, we will be better able to give patients fatigue management strategies that will improve their quality of life." 

Ancoli-Israel is also professor of psychiatry at UCSD School of Medicine, and director of the Sleep Disorders Clinic at the Veterans Affairs San Diego Healthcare System in La Jolla.

Study participants are monitored prior to and during the cycles of chemotherapy treatment. First, an in-home sleep recording is done to establish a baseline of each patient's sleep patterns. During chemotherapy cycles, an actigraph device is worn on the patient's wrist for 72 consecutive hours before and after each treatment. The small device measures movement, from which researchers can monitor the patient's sleep patterns.

An expert in the field of sleep disorders, Ancoli-Israel is applying what researchers already know about sleep patterns to the specific circumstances of breast cancer patients. Existing research shows that strength or regularity of sleep/wake patterns varies among individuals and that the patterns can be altered through light therapy. Ancoli-Israel hypothesizes that women with robust sleep/wake rhythms have an easier time fighting the fatigue that accompanies the disease and its treatment.

"By identifying how and why chemotherapy affects sleep patterns, the results of this study will be an important first step to developing specific fatigue management treatments for breast cancer patients," explained Ancoli-Israel.

Other Cancer Center members joining Ancoli-Israel as co-investigators on the study are Joel E. Dimsdale, M.D., professor of psychiatry; Vicky Jones, M.D., assistant professor of medicine; and Georgia Sadler, Ph.D., associate professor of surgery and associate director for community outreach, UCSD Cancer Center.

For further information about the study, contact Sherella Johnson at (858) 552-8585, Ext. 5919.

*Founded in 1979, UCSD Cancer Center was recently renamed the Rebecca and John Moores UCSD Cancer Center in honor of the Moores leadership gift to the Center. The Center is one of just 41 in the United States to hold a National Cancer Institute (NCI) designation as a Comprehensive Cancer Center.  As such, it ranks among the top centers in the nation conducting basic and clinical cancer research, providing advanced patient care and serving the community through outreach and education programs.