Sleep Disorders in Special Cases
Key Points for This Section
In patients with pain that disturbs their sleep, treatment to relieve the pain will be used before sleep medicines are used. Pain drugs, other drugs being taken, and any other health conditions may affect which sleeping medicines are prescribed.
It's normal for older people to have some insomnia. Changes related to age can cause lighter sleep, waking up more often during the night, and sleeping less total time. If an older patient with cancer is having trouble sleeping, the doctor will look for the specific causes, such as:
- Physical health problems.
- Mental health problems, such as anxiety or depression.
- Loss of social support.
- Alcohol use (drinking).
- Side effects of medicines.
- Conditions that commonly affect sleep, such as restless legs syndrome, cramping or jerking of the legs during sleep, and sleep apnea syndrome.
Treating sleeping problems without drugs is tried first. The following may help improve sleep in older patients:
- Having meals at regular times.
- Avoiding naps during the day.
- Being more active during the day.
Medicine may be used if non-drug treatments don't work. The doctor will look at all the patient's medicines and health conditions before choosing a sleeping medicine. For some patients, doctors will suggest a sleep disorder clinic for treatment.
Somnolence syndrome (SS) is a side effect of radiation therapy to the head and is often seen in children treated for acute lymphocytic leukemia. Children with SS seems to be sleepy all the time. They are less alert when awake, irritable, and have low energy and little appetite. There is sometimes a low-grade fever. The risk of SS increases when the total dose of radiation is given in fewer parts (fractions) and over a short period of time. The syndrome usually appears 4 to 6 weeks after radiation therapy ends. Up to half of children treated with radiation to the head may have SS.
Patients who have surgery on the jaw may develop sleep apnea, which is a sleep disorder that causes the person to stop breathing for 10 seconds or more during sleep. Plastic surgery to rebuild the jaw may help prevent sleep apnea.