Bibi Aneesah Jaumally1, Aneesa Das2, Nathaniel C Cassell1, G Nancy Pachecho3, Ruckshanda Majid1, Lara Bashoura3, Diwakar D Balachandran3, Saadia A Faiz4. 1. Divisions of Pulmonary, Critical Care Medicine and Sleep Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA. 2. Division of Pulmonary, Critical Care and Sleep, The Ohio State University, Columbus, OH, USA. 3. Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77030-1402, USA. 4. Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX, 77030-1402, USA. safaiz@mdanderson.org.
Abstract
PURPOSE: Excessive daytime sleepiness (EDS) is commonly reported in patients with cancer, and it is also a cardinal feature of central disorders of hypersomnolence. Multiple sleep latency testing (MSLT) is used for objective assessment. METHODS: A retrospective review of patients with cancer history who underwent formal sleep evaluation and MSLT from 2006 to 2019 was performed. Clinical characteristics, sleep-related history, and polysomnographic data were reviewed. RESULTS: Of 16 patients with cancer history, 9 were women (56%) and median age was 49. Cancer diagnoses included 4 central nervous system, 3 breast, 1 lymphoma, and 9 other solid malignancies, and 31% were undergoing active treatment. Comorbid conditions included depression, obstructive sleep apnea, and cancer-related fatigue. Daytime fatigue (94%), daily naps (81%), and EDS (69%) were the most common symptoms. Hypnopompic and hypnogogic hallucinations, sleep paralysis, sleep attacks, and cataplexy were present in a few. Epworth Sleepiness Scale scores were consistent with EDS in 88%, and mean sleep latency was less than 8 min in 69%. Only 31% had more than 2 sleep-onset REM periods. MSLT supported diagnoses of central disorders of hypersomnolence in 5 patients (4 narcolepsy, 1 idiopathic hypersomnia); 5 hypersomnia due to a medical disorder, psychiatric condition, or medication; and 6 with normal results. Pharmacotherapy was prescribed in 5 patients. CONCLUSIONS: EDS in patients with cancer may be multifactorial, but persistent symptoms may indicate an underlying disorder of hypersomnolence. Sleep referral and polysomnography to exclude other sleep disorders may be indicated. MSLT can help confirm the diagnosis. In those with normal MSLT, further evaluation for mood disorder should be considered.
PURPOSE: Excessive daytime sleepiness (EDS) is commonly reported in patients with cancer, and it is also a cardinal feature of central disorders of hypersomnolence. Multiple sleep latency testing (MSLT) is used for objective assessment. METHODS: A retrospective review of patients with cancer history who underwent formal sleep evaluation and MSLT from 2006 to 2019 was performed. Clinical characteristics, sleep-related history, and polysomnographic data were reviewed. RESULTS: Of 16 patients with cancer history, 9 were women (56%) and median age was 49. Cancer diagnoses included 4 central nervous system, 3 breast, 1 lymphoma, and 9 other solid malignancies, and 31% were undergoing active treatment. Comorbid conditions included depression, obstructive sleep apnea, and cancer-related fatigue. Daytime fatigue (94%), daily naps (81%), and EDS (69%) were the most common symptoms. Hypnopompic and hypnogogic hallucinations, sleep paralysis, sleep attacks, and cataplexy were present in a few. Epworth Sleepiness Scale scores were consistent with EDS in 88%, and mean sleep latency was less than 8 min in 69%. Only 31% had more than 2 sleep-onset REM periods. MSLT supported diagnoses of central disorders of hypersomnolence in 5 patients (4 narcolepsy, 1 idiopathic hypersomnia); 5 hypersomnia due to a medical disorder, psychiatric condition, or medication; and 6 with normal results. Pharmacotherapy was prescribed in 5 patients. CONCLUSIONS: EDS in patients with cancer may be multifactorial, but persistent symptoms may indicate an underlying disorder of hypersomnolence. Sleep referral and polysomnography to exclude other sleep disorders may be indicated. MSLT can help confirm the diagnosis. In those with normal MSLT, further evaluation for mood disorder should be considered.
Authors: Terri S Armstrong; Marcia Y Shade; Ghislain Breton; Mark R Gilbert; Anita Mahajan; Michael E Scheurer; Elizabeth Vera; Ann M Berger Journal: Neuro Oncol Date: 2017-03-01 Impact factor: 12.300
Authors: Dorela D Shuboni-Mulligan; Demarrius Young; Julianie De La Cruz Minyety; Nicole Briceno; Orieta Celiku; Amanda L King; Jeeva Munasinghe; Herui Wang; Kendra A Adegbesan; Mark R Gilbert; DeeDee K Smart; Terri S Armstrong Journal: Sci Rep Date: 2022-07-01 Impact factor: 4.996