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Nocturia, hot flashes may explain sleep disturbance during androgen deprivation therapy
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Hot flashes and nocturia may drive the association between androgen deprivation therapy and sleep disturbance among men with prostate cancer, according to findings published in Cancer.
“We were trying to better understand how common sleep disturbance is and what might be causing it among men treated with hormonal therapy for prostate cancer, Brian D. Gonzalez, PhD, assistant member of Moffitt Cancer Center in Tampa, Florida, told HemOnc Today. “We wanted to find whether the hot flashes and greater need to urinate overnight (i.e., nocturia) commonly seen in men receiving this treatment might help explain their worse difficulty sleeping.”
The researchers evaluated men either before or within 1 month of beginning ADT, and again at 6 and 12 months later (n = 78). They also assessed patients who were treated only with prostatectomy (n = 99) and matched controls with no cancer history (n = 108). Gonzalez and colleagues gathered self-reported sleep disturbance data as measured by the Insomnia and Severity Index and interference from hot flashes, measured by the Hot Flash Related Daily Interference Scale. The researchers assigned 100 participants to wear actigraphs for 3 days at the 6-month mark, and to report nocturia.
Compared with controls, men who received ADT reported worse sleep disturbance, greater hot flash interference and higher rates of clinically significant sleep disturbance (P ≤ .03).
Cross-sectional analyses of participants who wore actigraphs showed that patients undergoing ADT experienced more episodes of nocturia and greater objective sleep disturbance (P < .01).
The association between ADT and both objective and subjective sleep disturbance appeared to be partly explained by hot flashes and nocturia, according to cross-sectional mediation analyses (P < .05).
Gonzalez and colleagues acknowledged that the study was limited by its small, racially homogeneous sample size.
“As with previous studies, we found that men receiving hormonal therapy had worse objectively- and subjectively-assessed sleep than men in a control group. We also found that this sleep disturbance was partly attributable to the greater hot flashes and nocturia associated with hormonal therapy,” Gonzalez said. – by Andy Polhamus
Disclosures: The authors report no relevant financial disclosures.
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