Improving Your Sleep When You Have Mesothelioma

Dana NolanMental Health Counselor

Mesothelioma and Sleep Problems

Serious health challenges (like mesothelioma) affect sleep

Stress and worry affect sleep

Pain and treatment side effects can interrupt our sleep

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Personal and Society Problems Associated with Sleep Loss

100,000 auto crashes and 1500 deaths are attributed each year to sleep deprivation. $100 billion per year in lost productivity, medical expenses, sick leave and property damage is due to sleep loss. Poor quality of life: cranky, poor concentration,

lethargy and increased mistakes occur when we are sleep deprived.

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What Happens When We Sleep?

Divided into two separate types or phases:NREM (non rapid eye movement)REM (rapid eye movement)

Both phases have very different functions and we cycle regularly between these phases throughout our sleep.

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NREM Sleep (stages 1-4)

What happens: Metabolism slowsBrain is least active Blood pressure, heart rate, breathing rate are slowestDigestion increasesVITAL repair and renewal of body tissues and immune system

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NREM (con’t)

Stage 1: lasts 5-15 minutes and we feel like we are drifting in and out of sleep.

Stage 2: lasts about 15 minutes and we lose awareness of our surroundings. Heart rate, breathing and brain waves slow.

Stages 3 and 4: lasts about an hour. We are very hard to rouse in these stages. Body makes repairs at a cellular level.

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REM Sleep

Brain is very active and heart rate and breathing rate are faster.

Voluntary muscles are unable to move.

Cognitive restoration takes place. Our brain files away memories of important events during the day and disregards in insignificant events.

Psychological recuperation and working out of emotional issues.

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REM (con’t)

It is during this phase of sleep that we usually dream.

Eyes move during REM sleep and it is believed that our eyes move according to what we are dreaming about.

Heart rate and breathing rate correspond to our activity in our dream.

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Cycling through NREM and REM

We typically cycle through all these phases several times during the night.

It takes about 90 minutes to cycle through all the phases.

We spend more time in NREM sleep in the first half of the night and more time in REM in the last half of the night.

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Stages of Sleep Throughout the Night

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Mesothelioma and Cancer

Many reasons why sleep can be affected when someone has mesothelioma.

Treatment-related factors: chemo-induced bone pain or neuropathy, nausea, post-surgical pain, steroid-induced insomnia.

Psychological factors: anxiety can cause insomnia and depression can cause hypersomnia (too much sleep).

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How Mesothelioma Affects Sleep

Disease-related factors: discomfort due to fluid build up, pain related to tumor growth.

Lifestyle factors: increased caffeine intake to combat fatigue, lack of exercise and change in daily routine/schedule.

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Maximizing Sleep When You Have Mesothelioma

MedicationsPharmaceuticalOver the counter medications Supplements

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MedicationsTwo kinds of medications prescribed for sleep problems: hypnotics and anti-anxiety (benzodiazepines) medications

Hypnotics: Ambien, Lunesta, Restoril and Sonata(best to help you sleep a full 8 hours).

Benzodiazepines: Xanax, Valium, Klonopin, Ativan(best if anxiety or worrying is keeping you from falling asleep or staying asleep as they work for a few hours).

Clinical research shows that these medications are very effective in helping sleep problems in cancer patients.

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Over the Counter Sleep Aids Pain reliever sleep aids (Tylenol or Advil PM) and

Unisom are all antihistamine-based (like Benadryl) sleep aids which are available over the counter.

Some say that they feel “hung-over” and feel even more tired the next day after using these.

Both pain-reliever sleep aids can have adverse affects. Tylenol can lead to liver/kidney damage and chemotherapy is straining those organs. Regular use of Advil can lead to stomach upset and again patients on chemo may already be experiencing stomach upset.

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OTC Sleep Aids (con’t)

If using OTC sleep aids, just stick to antihistamine-based meds like Unisom or Sominex unless pain relief is needed.

All prescription or over the counter medications are recommended for short term insomnia in normal populations.

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Natural Supplements for Sleep

Melatonin - relatively safe supplement (see www.sleepfoundation.org for information on use of melatonin) for sleep. Mixed results in clinical studies on effectiveness in improving sleep.

Valerian root - National Cancer Institute

is currently conducting a clinical trial to see if this supplement is safe for cancer patients and helpful to improve sleep.

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Natural Supplements (con’t) Chamomile- either root extract or tea

has been found to be safe to use and reportedly has a calming or relaxing effect. But, clinical research doesn’t support its use for sleep problems.

Production of herbal supplements are not regulated by the FDA and caution should be used. Always tell your oncologist if you are taking any supplements as they may need to be discontinued before surgery or certain treatments.

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Conclusions

Difficulty sleeping or poor quality sleep is a common problem in our society.

Many reasons why a mesothelioma diagnosis can lead to poor sleep.

Many prescription, over the counter sleep aids and supplements provide options for short term sleep problems.

We will offer a future presentation on some behavioral and environmental suggestions to help with poor sleep.

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Contact Information

1-800-615-2270

(800) 615-2270