PURPOSE: Prostate cancer patients frequently report fatigue, sleep disturbance and insomnia, but polysomnographic data and underlying sleep disorders are not well described.
METHODS: All patients with prostate cancer who underwent polysomnography from 9/2006 to 1/2011 were identified. Clinical history and polysomnographic data were reviewed retrospectively. Preliminary data for 21 patients is presented.
RESULTS: Patients included 21 men with a median age of 69 (41-80) and median body mass index of 30.3 kg/m2 (23-58). Prostate cancer histology was adenocarinoma in all cases, except one patient with small cell neuroendocrine cancer. Eleven patients had local disease, and at the time of cancer diagnosis they had a median PSA 7 ng/mL(2-19) and median Gleason score of 7(6-9). Two patients had local recurrence, and 8 patients had metastatic disease. At the time of the sleep evaluation, most patients had active prostate cancer, but 3 patients were in clinical remission. Five patients were undergoing active chemotherapy. Ten patients were on active hormonal therapy with leuprolide(n=6), bicalutamide(n=1), and combination of leuprolide and bicalutamide (n=3). Four patients had a history of obstructive sleep apnea. Patients were referred for fatigue & hypersomnia(n=12), obstructive sleep apnea(OSA) symptoms(n=5), and perioperative assessment(4). Most patients complained of snoring(n=20), daytime fatigue/hypersomnia(n=21), nocturia(n=11) and multiple nocturnal awakenings(n=12). Thirty-nine sleep studies were performed, and 16 were baseline, 4 were split-night and 19 were positive pressure titration. Sleep disordered breathing was present in 16 patients(6 mild, 3 moderate, 7 severe) and concomitant sleep-related hypvoventilation/hypoxemia was present in 2 patients with severe OSA. The remaining 4 patients had periodic limb movement disorder. Twelve patients had low testosterone levels, and 9 of these patients had OSA. Thirteen patients were prescribe positive pressure therapy.
CONCLUSIONS: In our small cohort of prostate cancer patients, all had underlying sleep disorders.
CLINICAL IMPLICATIONS: Prospective epidemiologic studies are required to evaluate sleep disorders in patients with prostate cancer.
DISCLOSURE: The following authors have nothing to disclose: Saadia Faiz, Diwakar Balachandran, Brenda Remmert, Vickie Murphy, Nancy Pachecho, Stephen Mahoney, Leendert Keus, Paresh Patel, Lara Bashoura
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