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Sleep Initiation and Maintenance Disorders: HELP
Articles by Oxana G. Palesh
Based on 8 articles published since 2008
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Between 2008 and 2019, Oxana Palesh wrote the following 8 articles about Sleep Initiation and Maintenance Disorders.
 
+ Citations + Abstracts
1 Review Management of side effects during and post-treatment in breast cancer survivors. 2018

Palesh, Oxana / Scheiber, Caroline / Kesler, Shelli / Mustian, Karen / Koopman, Cheryl / Schapira, Lidia. ·Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA. · MD Anderson Cancer Center, Houston, TX, USA. · Department of Surgery, University of Rochester, Rochester, NY, USA. · Stanford Cancer Institute, Stanford, CA, USA. ·Breast J · Pubmed #28845551.

ABSTRACT: Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are commonly experienced symptoms that share psychological and physical manifestations. One or more of these symptoms will affect nearly all patients at some point during their course of treatment or survivorship. These side effects are burdensome and reduce patients' quality of life well beyond their cancer diagnosis and associated care treatments. Cancer-related fatigue, insomnia, and cancer-related cognitive impairment are likely to have multiple etiologies that make it difficult to identify the most effective method to manage them. In this review, we summarized the information on cancer-related fatigue, insomnia, and cancer-related cognitive impairment incidence and prevalence among breast cancer patients and survivors as well as recent research findings on pharmaceutical, psychological, and exercise interventions that have shown effectiveness in the treatment of these side effects. Our review revealed that most current pharmaceutical interventions tend to ameliorate symptoms only temporarily without addressing the underlying causes. Exercise and behavioral interventions are consistently more effective at managing chronic symptoms and possibly address an underlying etiology. Future research is needed to investigate effective interventions that can be delivered directly in clinic to a large portion of patients and survivors.

2 Review Sleep disruption in hematopoietic cell transplantation recipients: prevalence, severity, and clinical management. 2014

Jim, Heather S L / Evans, Bryan / Jeong, Jiyeon M / Gonzalez, Brian D / Johnston, Laura / Nelson, Ashley M / Kesler, Shelli / Phillips, Kristin M / Barata, Anna / Pidala, Joseph / Palesh, Oxana. ·Moffitt Cancer Center, Tampa, Florida. Electronic address: heather.jim@moffitt.org. · Department of Psychology, University of South Florida, Tampa, Florida. · Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California. · Moffitt Cancer Center, Tampa, Florida. · Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, California. · Moffitt Cancer Center, Tampa, Florida; Psychiatry and Legal Medicine PhD Program, Universitat Autònoma de Barcelona, Barcelona, Spain. · Department of Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, Florida. ·Biol Blood Marrow Transplant · Pubmed #24747335.

ABSTRACT: Sleep disruption is common among hematopoietic cell transplant (HCT) recipients, with over 50% of recipients experiencing sleep disruption pre-transplant, with up to 82% of patients experiencing moderate to severe sleep disruption during hospitalization for transplant and up to 43% after transplant. These rates of sleep disruption are substantially higher than what we see in the general population. Although sleep disruption can be distressing to patients and contribute to diminished quality of life, it is rarely discussed during clinical visits. The goal of the current review is to draw attention to sleep disruption and disorders (ie, insomnia, obstructive sleep apnea, restless legs syndrome) as a clinical problem in HCT in order to facilitate patient education, intervention, and research. We identified 35 observational studies published in the past decade that examined sleep disruption or disorders in HCT. Most studies utilized a single item measure of sleep, had small sample size, and included heterogeneous samples of patients. Six studies of the effects of psychosocial and exercise interventions on sleep in HCT have reported no significant improvements. These results highlight the need for rigorous observational and interventional studies of sleep disruption and disorders in HCT recipients..

3 Review Acupuncture in the treatment of cancer-related psychological symptoms. 2014

Haddad, Nadia Elisabeth / Palesh, Oxana. ·Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA nhaddad@stanford.edu. · Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. ·Integr Cancer Ther · Pubmed #24501113.

ABSTRACT: Acupuncture is being adopted by cancer patients for a wide range of cancer-related symptoms including highly prevalent psychological symptoms like depression, anxiety, insomnia, and impairment in quality of life. Pharmacological treatment of prevalent symptoms like anxiety, depression, and sleep disturbance can contribute to the high chemical burden already carried by cancer patients, creating additional side effects. As a result, patients and providers alike are interested in evidence-based nonpharmacologic alternatives like acupuncture for these symptoms. This article reviews the current literature (January 2000 through April 2013) for acupuncture in cancer-related psychological symptoms with attention to both efficacy and acupuncture-specific methodology. All published studies that met our review criteria demonstrate a positive signal for acupuncture for the treatment of depression, anxiety, sleep disturbance, and for improving quality of life with most results showing statistical significance. However, there are only a handful of acupuncture studies that were specifically designed to evaluate depression, sleep disturbance, and quality of life as primary outcomes, and no studies were found that looked at anxiety as a primary outcome in this population. Published studies in cancer patients and survivors show that acupuncture treatment is not only safe but also more acceptable with fewer side effects than standard of care pharmacological treatments like antidepressants. Finally, there is wide variability in both the implementation and reporting of acupuncture methods in the literature, with only 2 of 12 studies reporting full details of acupuncture methods as outlined in the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines, published in 2010 and providing an essential framework for the reporting of acupuncture methodology. This lack of methodological detail affects outcomes, generalizability, and validity of research involving acupuncture. Reasons for ongoing challenges in the development of high-quality acupuncture trials are discussed. In conclusion, results are encouraging for the development of randomized trials to directly evaluate the therapeutic impact of acupuncture in cancer-related psychological symptoms, including depression, anxiety, sleep disturbance, and quality of life, but attention to acupuncture methodological specific challenges in the development of high-quality research is necessary.

4 Article Secondary outcomes of a behavioral sleep intervention: A randomized clinical trial. 2019

Palesh, Oxana / Scheiber, Caroline / Kesler, Shelli / Gevirtz, Richard / Heckler, Charles / Guido, Joseph J / Janelsins, Michelle / Cases, Mallory G / Tong, Bingjie / Miller, Jessica M / Chrysson, Nick G / Mustian, Karen. ·Department of Psychiatry and Behavioral Sciences. · Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center. · Alliant International University. · Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center. · Cancer Control Trials, Metro-Minnesota Community Oncology Research Consortium. · Hematology and Oncology, Novant Health Oncology Specialists. · James P. Wilmot Cancer Institute, Department of Surgery University of Rochester Medical Center. ·Health Psychol · Pubmed #30762399.

ABSTRACT: OBJECTIVE: Nearly 80% of cancer patients struggle with insomnia, which is associated with decreased heart rate variability (HRV) and quality of life (QOL). The aim of this secondary analysis was to evaluate the possible effects of Brief Behavioral Therapy for Cancer-Related Insomnia (BBT-CI), delivered during chemotherapy visits, on QOL and HRV in patients with breast cancer (BC). METHOD: QOL and HRV data were obtained during a pilot clinical trial assessing the feasibility and effects of BBT-CI on insomnia. A total of 71 BC patients (mean age = 52.5 years) were randomly assigned to either BBT-CI or a healthy-eating control intervention (HEAL). BBT-CI and HEAL were delivered over 6 weeks (2 face-to-face sessions plus 4 phone calls) by trained staff at 4 National Cancer Institute-funded Community Oncology Research Program clinics. QOL was measured with the Functional Assessment of Cancer Therapy (FACT-G) and HRV with the Firstbeat device at baseline and after intervention. RESULTS: There were significant improvements in QOL after intervention for BBT-CI (FACT-G, p = .009; FACT-B, p = .016; ANCOVA) and 5-min supine HRV measures (SDNN, p = .005; rMSSD, p = .004; HF, p = .009; ANCOVA) compared with HEAL. CONCLUSIONS: Patients randomized to BBT-CI showed improvements in QOL and HRV, providing support for BBT-CI's possible benefit when delivered in the community oncology setting by trained staff. A more definitive efficacy trial of BBT-CI is currently being planned with sufficient statistical power to evaluate the intervention's clinical utility. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

5 Article Effects of childhood trauma exposure and cortisol levels on cognitive functioning among breast cancer survivors. 2017

Kamen, Charles / Scheiber, Caroline / Janelsins, Michelle / Jo, Booil / Shen, Hanyang / Palesh, Oxana. ·Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd, Box 420658, Rochester, NY 14642, USA. Electronic address: charles_kamen@urmc.rochester.edu. · Department of Psychiatry and Behavioral Sciences, Stanford University,401 Quarry Road, Stanford, CA 94305, USA. · Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd, Box 420658, Rochester, NY 14642, USA. ·Child Abuse Negl · Pubmed #28818733.

ABSTRACT: Cognitive functioning difficultiesin breast cancer patients receiving chemotherapy are common, but not all women experience these impairments. Exposure to childhood trauma may impair cognitive functioning following chemotherapy, and these impairments may be mediated by dysregulation of hypothalamic-pituitary-adrenal (HPA) axis function and cortisol slope. This study evaluated the association between childhood trauma exposure, cortisol, and cognition in a sample of breast cancer survivors. 56 women completed measures of trauma exposure (the Traumatic Events Survey), salivary cortisol, and self-reported cognitive functioning (the Functional Assessment of Cancer Therapy - Cognitive). We examined correlations between childhood trauma exposure and cognitive functioning, then used linear regression to control for factors associated with cognition (age, education, time since chemotherapy, depression, anxiety, and insomnia), and the MacArthur approach to test whether cortisol levels mediated the relationship between trauma and cognitive functioning. 57.1% of the sample had experienced at least one traumatic event in childhood, with 19.6% of the sample witnessing a serious injury, 17.9% experiencing physical abuse, and 14.3% experiencing sexual abuse. Childhood trauma exposure and cognitive functioning were moderately associated (r=-0.29). This association remained even when controlling for other factors associated with cognition; the final model explained 47% of the variance in cognitive functioning. The association between childhood trauma and cognitive functioning was mediated by steeper cortisol slope (partial r=0.35, p=0.02). Childhood trauma exposure is associated with self-reported cognitive functioning among breast cancer survivors and is mediated by cortisol dysregulation. Trauma should be considered, among other factors, in programs aiming to address cognition in this population.

6 Article Actigraphy-measured sleep disruption as a predictor of survival among women with advanced breast cancer. 2014

Palesh, Oxana / Aldridge-Gerry, Arianna / Zeitzer, Jamie M / Koopman, Cheryl / Neri, Eric / Giese-Davis, Janine / Jo, Booil / Kraemer, Helena / Nouriani, Bita / Spiegel, David. ·Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA. · Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA ; Tom Baker Cancer Centre, Psychosocial Resources, Calgary, Canada. ·Sleep · Pubmed #24790261.

ABSTRACT: BACKGROUND: Poor sleep, prevalent among cancer survivors, is associated with disrupted hormonal circadian rhythms and poor quality of life. Using a prospective research design, this study aimed to clarify the relationship between objective measures of sleep efficiency and sleep disruption with survival among women with advanced breast cancer. METHOD: We examined sleep quality and duration via wrist-worn actigraphy and sleep diaries for 3 days among 97 women in whom advanced breast cancer was diagnosed (age = 54.6 ± 9.8 years). Sleep efficiency was operationalized using actigraphy as the ratio of total sleep time to total sleep time plus wake after sleep onset. RESULTS: As hypothesized, better sleep efficiency was found to predict a significant reduction in overall mortality (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.94-0.98; P < 0.001) at median 6 y follow-up. This relationship remained significant (HR, 0.94; 95% CI, 0.91-0.97; P < 0.001) even after adjusting for other known prognostic factors (age, estrogen receptor status, cancer treatment, metastatic spread, cortisol levels, and depression). Secondary hypotheses were also supported (after adjusting for baseline prognostic factors) showing that less wake after sleep onset (HR, 0.41; 95% CI, 0.25-0.67; P < 0.001), fewer wake episodes, (HR, 0.93; 95% CI, 0.88-0.98; P = 0.007); and shorter wake episode duration (HR, 0.29; 95% CI, 0.14-0.58; P < 0.001) also contributed to reductions in overall mortality. CONCLUSIONS: These findings show that better sleep efficiency and less sleep disruption are significant independent prognostic factors in women with advanced breast cancer. Further research is needed to determine whether treating sleep disruption with cognitive behavioral and/or pharmacologic therapy could improve survival in women with advanced breast cancer.

7 Article Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program. 2010

Palesh, Oxana G / Roscoe, Joseph A / Mustian, Karen M / Roth, Thomas / Savard, Josée / Ancoli-Israel, Sonia / Heckler, Charles / Purnell, Jason Q / Janelsins, Michelle C / Morrow, Gary R. ·Department of Radiation Oncology, Department of Psychiatry, University of Rochester Medical Center, James P. Wilmot Cancer Center, 601 Elmwood Ave, Box 704, Rochester, New York, NY 14642, USA. oxana_palesh@urmc.rochester.edu ·J Clin Oncol · Pubmed #19933917.

ABSTRACT: PURPOSE: Sleep disruption is prevalent in patients with cancer and survivors, but the prevalence of insomnia, a distressing sleep disorder, in these populations has yet to be determined in large-scale studies. PATIENTS AND METHODS: A total of 823 patients with cancer receiving chemotherapy (mean age, 58 years; 597 female patients) reported on sleep difficulties in a prospective study. RESULTS: During day 7 of cycle 1 of chemotherapy, 36.6% (n = 301) of the patients with cancer reported insomnia symptoms, and 43% (n = 362) met the diagnostic criteria for insomnia syndrome. Patients with cancer younger than 58 years were significantly more likely to experience either symptoms of insomnia or insomnia syndrome (chi(2) = 13.6; P = .0002). Patients with breast cancer had the highest number of overall insomnia complaints. A significant positive association was found between symptoms of insomnia during cycles 1 and 2 of chemotherapy (phi = .62, P < .0001), showing persistence of insomnia during the first two cycles of chemotherapy. Sixty percent of the patient sample reported that their insomnia symptoms remained unchanged from cycle 1 to cycle 2. Those with insomnia complaints had significantly more depression and fatigue than good sleepers (all P < .0001). CONCLUSION: The proportions of patients with cancer in this sample reporting symptoms of insomnia and meeting diagnostic criteria for insomnia syndrome during chemotherapy are approximately three times higher than the proportions reported in the general population. Insomnia complaints persist throughout the second chemotherapy cycle for the majority of patients with cancer in this study. Insomnia is prevalent, underrecognized, undermanaged, and understudied among patients with cancer receiving chemotherapy.

8 Article Vagal regulation, cortisol, and sleep disruption in women with metastatic breast cancer. 2008

Palesh, Oxana / Zeitzer, Jamie M / Conrad, Ansgar / Giese-Davis, Janine / Mustian, Karen M / Popek, Varinia / Nga, Karen / Spiegel, David. ·University of Rochester Wilmot Cancer Center, Rochester, NY, USA. Oxana_Palesh@urmc.rochester.edu ·J Clin Sleep Med · Pubmed #18853702.

ABSTRACT: STUDY OBJECTIVES: To determine the relationship between hypothalamic pituitary axis (HPA) dysregulation, vagal functioning, and sleep problems in women with metastatic breast cancer. DESIGN: Sleep was assessed by means of questionnaires and wrist actigraphy for 3 consecutive nights. The ambulatory, diurnal variation in salivary cortisol levels was measured at 5 time points over 2 days. Vagal regulation was assessed via respiratory sinus arrhythmia (RSA(TF)) during the Trier Social Stress Task. PARTICIPANTS: Ninety-nine women (54.6 +/- 9.62 years) with metastatic breast cancer. RESULTS: Longer nocturnal wake episodes (r = 0.21, p = 0.04, N=91) were associated with a flatter diurnal cortisol slope. Sleep disruption was also associated with diminished RSA(TF). Higher RSA baseline scores were significantly correlated with higher sleep efficiency (r = 0.39, p = 0.001, N=68) and correspondingly lower levels of interrupted sleep (waking after sleep onset, WASO; r = -0.38, p = 0.002, N=68), lower average length of nocturnal wake episodes (r = -0.43, p < 0.001, N=68), and a lower self-reported number of hours of sleep during a typical night (r = -0.27, p = 0.02, N=72). Higher RSA AUC was significantly related to higher sleep efficiency (r = 0.45, p < 0.001, N=64), and a correspondingly lower number of wake episodes (r = -0.27, p = 0.04, N=64), lower WASO (r = -0.40, p = 0.001, N=64), and with lower average length of nocturnal wake episodes (r = -0.41, p = 0.001, N=64). While demographics, disease severity, and psychological variables all explained some portion of the development of sleep disruption, 4 of the 6 sleep parameters examined (sleep efficiency, WASO, mean number of waking episodes, average length of waking episode) were best explained by RSA. CONCLUSIONS: These data provide preliminary evidence for an association between disrupted nocturnal sleep and reduced RSA the subsequent day, confirming an association between disrupted nocturnal sleep and flattened diurnal cortisol rhythm in women with metastatic breast cancer. They suggest that the stress-buffering effects of sleep may be associated with improved parasympathetic tone and normalized cortisol patterns during the day.