title: Sleep disturbance in adults with cancer: a systematic review of evidence for best practices in assessment and management for clinical practice.
abstract: Sleep disturbance is prevalent in cancer with detrimental effects on health outcomes. Sleep problems are seldom identified or addressed in cancer practice. The purpose of this review was to identify the evidence base for the assessment and management of cancer-related sleep disturbance (insomnia and insomnia syndrome) for oncology practice. The search of the health literature included grey literature data sources and empirical databases from June 2004 to June 2012. The evidence was reviewed by a Canadian Sleep Expert Panel, comprised of nurses, psychologists, primary care physicians, oncologists, physicians specialized in sleep disturbances, researchers and guideline methodologists to develop clinical practice recommendations for pan-Canadian use reported in a separate paper. Three clinical practice guidelines and 12 randomized, controlled trials were identified as the main source of evidence. Additional guidelines and systematic reviews were also reviewed for evidence-based recommendations on the assessment and management of insomnia not necessarily in cancer. A need to routinely screen for sleep disturbances was identified and the randomized, controlled trial (RCT) evidence suggests benefits for cognitive behavioural therapy for improving sleep quality in cancer. Sleep disturbance is a prevalent problem in cancer that needs greater recognition in clinical practice and in future research.
authors.affiliation: University Health Network & Faculty of Nursing, University of Toronto, Toronto; Canadian Partnership Against Cancer, Toronto. Electronic address: doris.howell@uhn.on.ca.
authors.forename: D
authors.initials: D
authors.lastname: Howell
authors.affiliation: Canadian Partnership Against Cancer, Toronto.
authors.forename: T K
authors.initials: TK
authors.lastname: Oliver
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto.
authors.forename: S
authors.initials: S
authors.lastname: Keller-Olaman
authors.affiliation: Departments of Psychology and Oncology, Queen's University, Kingston; Kingston Family Health Team, Kingston.
authors.forename: J R
authors.initials: JR
authors.lastname: Davidson
authors.affiliation: Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary; Department of Psychology, University of Calgary, Calgary.
authors.forename: S
authors.initials: S
authors.lastname: Garland
authors.affiliation: Centre for Sleep and Human Performance in Calgary, Calgary.
authors.forename: C
authors.initials: C
authors.lastname: Samuels
authors.affiliation: School of Psychology, Université Laval, Quebec City.
authors.forename: J
authors.initials: J
authors.lastname: Savard
authors.affiliation: Department of Psychology and Psychosocial Oncology Program, The Ottawa Hospital Cancer Centre, Ottawa.
authors.forename: C
authors.initials: C
authors.lastname: Harris
authors.affiliation: Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City.
authors.forename: M
authors.initials: M
authors.lastname: Aubin
authors.affiliation: Faculty of Nursing, University of Alberta, Alberta.
authors.forename: K
authors.initials: K
authors.lastname: Olson
authors.affiliation: Department of Oncology, Juravinski Cancer Centre, Hamilton.
authors.forename: J
authors.initials: J
authors.lastname: Sussman
authors.affiliation: Department of Pediatrics & Psychiatry, University of Toronto, Toronto; MedSleep (Network of Clinics), Toronto.
authors.forename: J
authors.initials: J
authors.lastname: MacFarlane
authors.affiliation: Department of Nursing, Cape Breton University, Sydney, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Taylor
mesh_terms: D002170:Canada; D003362:Cost-Benefit Analysis; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000473:pathology; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000473:pathology / Q000628:therapy*
keywords: cancer; insomnia; interventions; review; sleep disturbance