Sleep, Stress, and Fatigue Central Washington University E.A.S.E. Cancer Foundation Tim Burnham Ph.D.
Interrelated Stress Sleep disturbance Fatigue
Stress Stress is YOUR response to a situation Stressor: good (eustress) or bad (distress) ACTH, Adrenaline, Cortisol Increase BP, HR, Breathing, sweat Increase blood glucose, free fatty acids Response is the same despite cause
Chronic Distress Multifaceted, unpleasant physical and emotional experience that may interfere with the ability to cope effectively with cancer, it s physical symptoms and treatment Continuum: common normal feelings of vulnerability, sadness and fears to disabling feelings: depression, anxiety, panic, social isolation and spiritual crisis
Common Stressors Worries about getting cancer again Reduced stamina and mental sharpness Finances and keeping affordable health insurance Relationships Finding or keeping a job Sharing your cancer experience with others
Stress and Health Cancer survivors have high levels of physical and emotional stress High levels of stress hormones ACTH, adrenaline, cortisol Decrease immune function: antibody production and inhibit NK cell activity May increase risk of cancer recurrence and infections
Other health issues Increase blood pressure and cholesterol Increase blood sugar More likely to have unhealthy diet, smoke, lack exercise Increased risk of other diseases, in particular cardiovascular disease
Signs that a person is stressed Headaches Loss of appetite or eating too much Body aches and pains Pounding heart Grinding teeth Tense muscles Fatigue
Signs that someone is stressed Mood swings Difficulty concentrating or making decisions Nightmares Worrying Forgetfulness Sleep problems
Ways to decrease stress Exercise Improves mood Decreases stress hormones Improves immune function Regulates energy balance and fat distribution Lowers estrogen
Ways to decrease stress Breathing and relaxation techniques (guided imagery, progressive muscle relaxation, meditation) Yoga or Tai Chi Support groups Write in a journal Ask for help with daily activities Learn to say no
Ways to decrease stress
Cancer Related Fatigue Profound fatigue related to cancer or it s treatment 76-99% of cancer survivors have CRF CFR can significantly decrease activities of daily living, decrease quality of life including socializing, the ability to enjoy life and decreased emotional well being
Cancer Related Fatigue Not limited to the time during treatment, can last for years CRF greater than exercise induced fatigue, remains after rest, more severe and debilitating Both physiological and psychological aspects
Cancer Related Fatigue Psycho-social factors related to CRF: sleep mood disturbance chronic stress anxiety pain depression cognitive disturbance
Cancer Related Fatigue: other causes Cachexia: muscle wasting Anemia: lack of hemoglobin Chemotherapy, radiation Decreased nutrition
Ways to Decrease Fatigue Exercise decreases fatigue Decreases depression Improves muscle function Counteracts anemia Think of you personal energy stores as a bank, deposits and withdrawals of energy must be balanced over the day
Ways to Decrease Fatigue Plan ahead and organize your work Schedule rest breaks Pace yourself Practice proper body mechanics Limit isometric work Prioritize activities to save energy Eat properly
Sleep Importance of sleep and treatment of sleep disturbances has only been studied recently 50% of cancer survivors have sleep disturbances (9-12% in general population) Negative relationship between sleep and fatigue, the greater the sleep, the less fatigue
Ways to improve sleep Exercise Yoga Avoid long afternoon naps Go to bed only when sleepy Avoid caffeine in the evenings Progressive muscle relaxing Breathing exercises If you toss and turn get out of bed Meditation
Relationship between Sleep, Stress and Fatigue Stress, fatigue and sleep disturbance are all separate entities. However, they are all related to each other. Learning techniques to reduce stress and fatigue and increase sleep and sleep quality can improve quality of life.
Relationship between Sleep, Stress and Fatigue A simple goal of starting an exercise plan can work wonders. Walking 15-20 minutes, 3 times a week, at an intensity that allows you to maintain a conversation, would be a good step towards increasing sleep, reducing fatigue and managing stress.