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insomnie et cancer

Voici un aperçu des publications récentes liées au sommeil extraites de la base Pubmed. Les résumés de ces articles en instance de parution, ainsi que leurs références, sont restituées en fin de message.

- Quel est l’impact de l’insomnie chez les patients atteints du cancer et ayant survécu et quelles en sont les formes évolutives ? Ce sont certaines des questions qui ont suscité l’élaboration d’une enquête qualitative auprès de 21 anciens malades du cancer par des chercheurs de Glasgow. Cette enquête révèle notamment que l'apparition de l’insomnie est contemporaine de l’annonce du diagnostic de cancer tandis que les patients souffrant déjà d’insomnie la voient s’exacerber avec les traitements actifs prescrits contre la maladie. Cette étude est en instance de parution dans la revue Psychooncology.

-La revue Brain Research Bulletin met à l’épreuve l’hypothèse d’un fonctionnement optimal précoce du processus cognitif dans la formation des rêves chez les patients atteints de narcolepsie-cataplexie.

-Une étude parue dans la revue Neuroimage s’interroge sur l’incidence de la privation de sommeil sur un type spécifique d’attention : l’attention dite sélective.

-La revue Brain, Behavior and Immunity publie un article sur la corrélation entre manque de sommeil et troubles d’ordre inflammatoire à travers une analyse différentielle en fonction des sexes.

-Les brûlures d’estomac et le reflux gastro-œsophagien lié au sommeil associé méritent d’être considérés comme une entité clinique à part entière et être pris en compte dans le diagnostic et le traitement des  œsophagites et maladies apparentées. C’est ce que tend à démontrer une étude à paraître dans la revue  Alimentary, Pharmacology and Therapeutics.


Psychooncology.. [Epub ahead of print]

The development and impact of insomnia on cancer survivors: a qualitative analysis.

Fleming L, Gillespie S, Espie CA.

University of Glasgow Sleep Centre, Southern General Hospital, Glasgow, UK.

Objectives: To conduct the first qualitative analysis of the development and impact of insomnia on a cohort of cancer survivors.Methods: Twenty-one cancer survivors with a history of chronic insomnia contributed to four focus groups held at the University of Glasgow Sleep Research Centre. Participants' perceptions of the onset, evolution and effects of insomnia were elicited and qualitatively explored using content analysis.Results: Most participants reported insomnia onset following cancer diagnosis. Participants who had a pre-existing insomnia reported that cancer diagnosis significantly aggravated their sleep complaint. Active cancer treatment was a major contributor to poor sleep quality due to the disruption of normal daily routines. This poor sleep pattern became persistent once active treatment had ceased and participants reported becoming particularly concerned about their sleep when they were discharged into follow-up cancer care. The impact of insomnia was significant for all participants in the study and six major areas emerged as being particularly affected; mood, physical health, relationships, sleep quality, sleep-related behaviour and cognition. Conclusions: The majority of cancer survivors in this study developed disturbed sleep as a result of cancer diagnosis and their sleep disruption was exacerbated by active cancer treatment. Insomnia also had a significant impact upon quality of life and these effects persisted long beyond the cessation of active anti-cancer therapy. Early identification of insomnia symptoms in cancer care settings must be a priority to ensure that sleep disturbance is not overlooked or poorly managed. Copyright (c) 2009 John Wiley & Sons, Ltd.

PMID: 20014075 [PubMed - as supplied by publisher]


Brain Research Bulletin. 2010 Jan 15;81(1):133-40.

REM-dreams recall in patients with narcolepsy-cataplexy.

Mazzetti M, Bellucci C, Mattarozzi K, Plazzi G, Tuozzi G, Cipolli C.

Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy. michela.mazzetti@unibo.it

An abundant recall of dreams has been observed in clinical studies on patients with narcolepsy-cataplexy (NC), a neurological disorder characterized by an altered sleep architecture. Laboratory studies have shown that dream experiences developed during 1st-rapid eye movement (REM) sleep by NC patients are longer and more complex than those of healthy subjects. To establish whether these features indicate an earlier optimal functioning of the cognitive processes involved in dream generation rather than a more accurate dream recall, we compared the indicators of length and structural organization in reports of REM-dreams collected from 14 NC patients and their matched controls. During an experimental night two awakenings were provoked after 8 min in 1st- and 3rd-REM sleep; participants were asked to report their dream experience (spontaneous report) and then, if possible, further remembered parts of this experience (prompted report). All reports were analyzed using story-grammar rules, which allow us to identify units larger than single contents and describe their story-like organization. While dream recall (about 90%) was comparable in NC patients and controls, 1st-REM spontaneous reports were longer and more complex in NC patients, half of whom also provided prompted reports. After 3rd-REM awakening more than one third of NC patients and controls gave prompted reports, which were fairly comparable in length and complexity with the spontaneous reports. These findings confirm that the cognitive processes underlying dream generation reach their optimal functioning earlier in the night in NC patients than in normal subjects, and raises the question of whether the dream-stories described in spontaneous and prompted reports are part of the same or distinct REM-dreams.

PMID: 19897020 [PubMed - in process]


Neuroimage. 2010 Jan 15;49(2):1903-10. Epub 2009 Sep 15.

Sleep deprivation and its effects on object-selective attention.

Chee MW, Tan JC, Parimal S, Zagorodnov V.

Cognitive Neuroscience Laboratory, Duke-NUS Graduate Medical School, Singapore. michael.chee@duke-nus.edu.sg

Sleep deprivation (SD) affects attention but it is an open question as to whether all subtypes of attention are similarly affected. We investigated the effects of 24 h of total SD on object-selective attention. 26 healthy, young adults viewed quartets of alternating faces or place scenes and performed selective judgments on faces only, scenes only or both faces and scenes. Volunteers underwent fMRI following a normal night of sleep and again following approximately 24 h of total sleep deprivation in a counterbalanced fashion. Sleep deprivation resulted in slower and less accurate picture classification as well as poorer recognition memory for scenes. Attention strongly modulated activation in the Parahippocampal Place Area (PPA). Task-related activation in the fronto-parietal cortex and PPA was reduced in SD, but the relative modulation of PPA activation by attention was preserved. Psychophysiological interaction between the left intra-parietal sulcus and the PPA that was clearly present after a normal night of sleep was reduced below threshold following SD suggesting that PPI may be a more sensitive method of detecting change in selective attention. Sleep deprivation may affect object-selective attention in addition to exerting a task-independent deficit in attention.



Brain, Behavior and Immunity. 2010 Jan;24(1):54-7. Epub 2009 Jun 9.

Sleep loss activates cellular markers of inflammation: sex differences.

Irwin MR, Carrillo C, Olmstead R.

University of California, Los Angeles - Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90095-7076, USA. mirwin1@ucla.edu

Sleep disturbance is associated with inflammation and related disorders including cardiovascular disease, arthritis, and diabetes mellitus. Given sex differences in the prevalence of inflammatory disorders with stronger associations in females, this study was undertaken to test the effects of sleep loss on cellular mechanisms that contribute to proinflammatory cytokine activity. In 26 healthy adults (11 females; 15 males), monocyte intracellular proinflammatory cytokine production was repeatedly assessed at 08:00, 12:00, 16:00, 20:00, and 23:00h during a baseline period and after partial sleep deprivation (awake from 23:00 to 3.00h). In the morning after a night of sleep loss, monocyte production of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) differentially changed between the two sexes. Whereas both females and males showed a marked increase in the lipopolysaccharide (LPS) - stimulated production of IL-6 and TNF-alpha in the morning immediately after PSD, production of these cytokines during the early- and late evening was increased in the females as compared to decreases in the males. Sleep loss induces a functional alteration of monocyte proinflammatory cytokine responses with females showing greater cellular immune activation as compared to changes in males. These results have implications for understanding the role of sleep disturbance in the differential risk profile for inflammatory disorders between the sexes.

PMID: 19520155 [PubMed - in process]


Alimentary Pharmacology and Therapeutics. 2010 Jan;31(1):47-56.

Review article: sleep-related gastro-oesophageal reflux as a distinct clinical entity.

Orr WC.

Lynn Health Science Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73112, USA. worr@lhsi.net

BACKGROUND: Many patients with chronic gastro-oesophageal reflux disease (GERD) have frequent nighttime heartburn as well as sleep-related gastro-oesophageal reflux (GOR). Sleep-related GOR has been shown to play an important role in the development of oesophagitis and other complications of GOR. AIM: To present a conceptual argument that nighttime heartburn and associated sleep-related GOR should be recognized as a distinct clinical entity deserving special attention with regard to the diagnosis and treatment of GERD. METHODS: The data presented come from surveys of GERD patients as well as from physiological studies to include studies monitoring oesophageal pH and spontaneous reflux events during polysomnographically (PSG) monitored sleep. RESULTS: Evidence is presented to show that nighttime heartburn is prevalent and its occurrence separates patients from those who have heartburn most exclusively in the daytime. The evidence presented also supports the notion that nighttime heartburn sufferers have a more complicated disease and they have a greater risk of developing oesophagitis and other respiratory complications. The data also show that responses to acid mucosal contact are quite different during sleep compared to responses measured during the waking state. CONCLUSIONS: Nighttime heartburn and GOR represent a distinct clinical entity which deserves specific attention in the diagnosis and optimal treatment of GERD.

PMID: 19691671 [PubMed - in process]

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