Hypnotic Use for Sleep Disturbances in Breast Cancer: A Systematic Review.
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Date
2013-07
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Abstract
Aims: Sleep disturbances are common in patients with breast cancer. The aim of this
systematic review was to present the literature on pharmacological interventions against
sleep disturbances and use of hypnotics in patients with breast cancer. We wanted to
study patients both in the perioperative period as well as when they were receiving
oncological (medical) treatment.
Study Design: Systematic review.
Methodology: According to the PRISMA guidelines, a literature search was performed
on May 10th 2012 in Pubmed and Embase. Primary outcomes were pharmacological
interventions against sleep disturbances. No restriction on publication status was made.
Only articles in English were included. Case reports and studies with less than ten
patients were excluded.
Results: Five studies met the inclusion criteria and were included in the review. One
study investigated pharmacological intervention in the perioperative period and showed
that treatment with triazolam significantly improved sleep three consecutive nights after
surgery. Two studies investigated patients undergoing endocrine oncological treatment.
The studies showed that zolpidem combined with an SSRI/SNRI improved sleep in
patients having hot flashes, and that hypnotics were prescribed significantly more often
in patients undergoing endocrine treatment compared with healthy patients not
receiving endocrine treatment. Two studies investigated patients receiving chemotherapy. The studies showed that hypnotics were prescribed to almost every
second patient. Prior users of hypnotics and patients with a psychiatric diagnosis were
more likely to take hypnotics during chemotherapy.
Conclusion: Sleep disturbances occur frequently in patients with breast cancer
indicated by the high prevalence of hypnotic use. It therefore is of concern that only few
clinical trials exist on pharmacological intervention against sleep disturbances in the
different treatment time periods. At present, there is insufficient evidence to recommend
one single pharmacological intervention in this patient group.
Description
Keywords
Breast cancer, sleep disturbances, hypnotics
Citation
Andersen Lærke Toftegård, Rosenberg Jacob, Gögenur Ismail. Hypnotic Use for Sleep Disturbances in Breast Cancer: A Systematic Review. British Journal of Medicine and Medical Research. 2013 Jul-Sep; 3(3): 596-607.