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Breast cancer patients needed for study of new ways to treat sleep problems

- By Michelle Brandt

Oxana Palesh

Oxana Palesh

Last year, clinical psychologist Oxana Palesh, PhD, MPH, published a study showing that the rates of insomnia in cancer patients undergoing chemotherapy are nearly three times higher than the rates in the general population. “Insomnia is prevalent, under-recognized, undermanaged and understudied” among these patients, she and her co-authors concluded.

Now, Palesh is launching a study at the Stanford University School of Medicine to test two methods for preventing and reducing insomnia and fatigue in breast cancer patients. She and her colleagues are looking for women who have at least six weeks of chemotherapy or biologic treatment scheduled and who have some difficulty falling or staying asleep. Their sleep problems must have begun or worsened after their cancer diagnosis.

Those interested in participating or learning more about the trial should call (650) 725-7011 or e-mail opalesh@stanford.edu.

Palesh’s research focuses on the impact of cancer treatments on sleep, fatigue and quality of life; she conducted the insomnia study while at the University of Rochester in Rochester, N.Y. As this paper and others have shown, sleep difficulties are common among cancer patients. “We know that about 80 percent of women diagnosed with breast cancer and undergoing chemotherapy will have some level of sleep disturbance,” said Palesh, now an acting assistant professor of psychiatry and behavioral sciences at Stanford.

Palesh said it’s unclear exactly why sleep problems occur — they could be caused by stress, the treatment or even the disease itself — but it’s a serious issue that is gaining attention among physicians and researchers. “There is an emerging awareness that sleeping well and managing fatigue during cancer is important for quality of life and might affect how you respond to treatment,” she said.

During this National Cancer Institute-funded study, 64 participants will be randomly assigned to receive a brief behavioral treatment for sleep problems; a drug called armodafinil (brand name Nuvigil) that may be helpful in reducing daytime tiredness and fatigue; both the treatment and medication; or a placebo for six weeks. They will complete questionnaires, wear a watchlike device to record sleep information and provide blood and saliva samples; they will be evaluated during four brief visits to Stanford over the course of eight months.

“There is currently no standard treatment for insomnia and fatigue in cancer patients,” said Palesh, who is also a member of the Stanford Cancer Center. “This research can shed new light on effective treatments for women with breast cancer having sleep difficulties.”

Stanford Medicine integrates research, medical education and health care at its three institutions - Stanford University School of Medicine, Stanford Health Care (formerly Stanford Hospital & Clinics), and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu.

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