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A7292 - Hypersomnia in Cancer Patients Based on Multiple Sleep Latency Testing
Author Block: N. Cassell1, D. D. Balachandran2, L. Bashoura3, S. A. Faiz4; 1Pulmonary, Critical Care and Sleep Medicine, University of Texas McGovern Medical School, Houston, TX, United States, 2Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States, 3Pulmonary Medicine, The University of Texas at MD Anderson Cancer Center, Houston, TX, United States, 4Pulmonary, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Background. Subjective complaints of fatigue, daytime sleepiness and insomnia are frequently reported by cancer patients. Potential etiologies may include systemic effects of underlying malignancy, chemotherapy and radiation. Significant obstructive sleep apnea (OSA) has been described in patients with head and neck cancer, and hypersomnia has been reported in central nervous systems (CNS) tumors after radiation therapy. There is a dearth of information, however, regarding cancer patients and hypersomnia. Purpose. Our purpose was to evaluate disorders of hypersomnia in cancer patients. Methods. We performed a retrospective review of patients who underwent at least one multiple sleep latency test (MSLT) at the MD Anderson Cancer Center from 11/1/2006 to 11/1/2017. Clinical history and laboratory data were extracted and analyzed. Results. Preliminary data identified 16 patients with 9 females and 7 males. Median age was 49 years (15 to 69), and median body mass index was 28.4 kg/m2 (17.7 to 47.9). Most patients (13) had active solid tumor malignancies with 3 from CNS tumors, and a few (3) had no active cancer for the past 5 years. No patient received radiation therapy to the brain. Patients were referred for sleep evaluation due to fatigue (14), sleep apnea symptoms (3), and other (2). Previous sleep disorders included OSA (5), cancer-related fatigue (4), and restless legs syndrome (1). Additional therapies included sleep aides (4), depression/anxiety agents (8), pain medications (4), stimulant therapy (5) and steroids (1). Hypertension, depression and hypothyroidism were the most common co-morbidities. Performance status was between ECOG 0 to 2. Epworth Sleepiness Score was greater than 10 in most (15). MSLT revealed idiopathic hypersomnia (8), narcolepsy (4) and normal (4). Concomitant sleep disorders diagnosed included obstructive sleep apnea (9), inadequate sleep hygiene (6), and periodic limb movement disorder (1). Treatment for hypersomnia with stimulant medication was prescribed in 10 patients. Conclusion. Disorders of hypersomnia may rarely occur in cancer patients, and they may contribute to their symptom burden. Risk of these disorders may not just be limited to CNS malignancies or those treated with radiation to the brain. A high clinical suspicion is needed to detect these disorders, and MSLT may provide valuable diagnostic information. Further study is needed.