Dr Neil Stanley Independent Sleep Expert
BACK George W. Sledge Jr., ‘Perchance to Dream’, Oncology Times, 27 Feb. 2012. here.  It is clear that this Oncologist did not come to this conclusion based on any research merely an uncritical acceptance of the premise of Ekirch’s original paper. What Is ‘Normal’? What is a “normal” sleep pattern? This turns out to be an interesting historical question. As recently as 200 years ago, sleep patterns differed significantly from ours. Roger Ekirch, a professor of history at Virginia Tech, wrote a wonderful book on the subject called At Day’s Close: Night in Times Past. Ekirch documents, through analysis of hundreds of primary sources, that our ancestors commonly had a “first sleep” followed by a period of wakefulness, followed in turn by a “second” or “morning” sleep. This pattern, a function of living in a night that was both long and dark, disappeared with modern home and street lighting systems.   In other words, we all sleep abnormally, at least in historical terms, though some more abnormally than others. My cancer patients frequently complain about their sleep, or lack thereof, particularly in the months following chemotherapy. As many as 45% of cancer patients complain of sleeplessness in some series, though like everything else in the quality-of-life realm, we do a poor job documenting the problem, and an even poorer job of understanding.   Sleep disorders in cancer patients cluster with other problems (fatigue, pain, depression, loss of concentration, and other cognitive dysfunctionality), making it hard to tease out cause and effect. The correlation between fatigue and sleep loss in particular is a vexing chicken-and-egg question, or so the literature would suggest.   Does any of this matter from a cancer standpoint? If you don’t get a good night’s sleep, will your micrometastases wake up? We don’t really know, but if you mimic obstructive sleep apnea in mice by exposing them to intermittent hypoxia, their tumors grow at a more rapid rate. That hypoxia can make tumors grow is no surprise, but of course sleep apnea is only one of many sleep disorders. BACK
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