Occasionally, incorrect and misleading representations of sleep needs, as if linked absolutely to increased breast cancer risk, have been posted on the internet, producing unnecessary worry about sleep patterns. One report suggested that an inverse association between sleep duration and breast cancer risk could seriously threaten risk of this diagnosis. In that particular post it was stated that 8 continuous hours of sleep, or more, every night would be essential to avoiding a breast cancer. Yet this statement is scientifically countered by solid research such as the systematic review published in 2017 that concluded, “Compared to women with the reference number of sleep hours, women with a longer sleep duration might have an increased risk of breast cancer, especially estrogen receptor-positive breast cancer.” (Biomed Res Int. 2017). Let me add that if the 8-hour imperative were accurate, every woman with small children who awaken in the middle of night would be seriously at risk for breast cancer.
A big concern that results from suggesting that longer durations of unbroken sleep are a necessary preventative measure is that many women who are extremely conscientious about any and all preventative measures for diminishing risk of diseases such as breast cancer, based on these mistaken recommendations might lie in bed awake, worrying and fretting that their sleep is dangerously inadequate Too often they might believe that a continuous, uninterrupted 8 hours is a sleep imperative.
In addition to the above systematic review is the following finding: as we age to 65 and older, needing to sleep routinely more 8 1/2 hours regularly might be attributed by sleep experts to ill health. (Perhaps increased sleep needs are not unusual, however, for anyone receiving radiation therapy, recently recovering from surgery or other taxing treatments.) Moreover, awake and worrying about insufficient sleep – even though routinely experiencing 7-hour total sleep and awakening without difficulty, meaning, refreshed and ready to start their day – might actually reduce sleep. That is, lying in bed concerned because about lying in bed awake can easily result in the release of catecholamines, such as adrenaline, and glucocorticoids, such as cortisol, which can prevent sleep. These stirred-up stress hormones in the late night hours can also interfere with normal melatonin, producing hyper-arousal with faster brain wave patterns, definitely counterproductive to sleep.
As an important reassurance, we humans are bi-phasic or multi-phasic, meaning we can sleep three hours, perhaps go to the bathroom, return to bed and fall back to sleep within approximately 15 minutes and continue to sleep another four hours. The good news is that this pattern can be fine. In fact, there used to be a cultural norm which was labeled, “First sleep and second sleep,” acknowledging that for many people, two sleep periods per night was a common pattern, and not harmful. Therefore, it seems helpful to return to an earlier blog posted on our Face Book page, which included the sub-heading “Don’t lose sleep over losing sleep,” a message intended to be reassuring, and not just a glib statement.
On this issue of sleep duration, a landmark population study conducted at the University of California, Irvine, found that in the six years of research among adults classified as “healthy” (indicating that they hadn’t just left a hospital stay nor just experienced surgery, which can potentially disrupt circadian rhythms) those who slept on average 7 hours, seemed to be living longer on average than those sleeping 8. There are certainly times when rebuilding after treatment, radiation, or surgery when 8, 8 ½ or 9 hours might feel necessary. Moreover, power naps — brief, less than 40 minutes — may be important for recharging. One reason to keep these shorter naps around 20-30 minutes is that at approximately 45 minutes, we humans enter deep sleep phases 3 and 4, which might disrupt deep sleep later during the night.
None of this is to say that we don’t help individuals with breast cancer and other diagnoses of cancer improve their sleep. We do have a sleep specialist on our whole systems team at the Block Center. Having difficulty awakening in the morning or after sleeping is a sign that you might need help. A system that our staff is trained in called CBT-I (Cognitive Behavioral Therapy for Insomnia) has been found to be very effective for insomnia (if not due to sleep apnea (a significant problem that requires medical attention). Addressing healthy circadian rhythms as well as sleep efficiency is part of every patient’s full initial visit, typically addressed in Biobehavioral sessions, and is available to any who feel their sleep is not sufficient. Please contact us at Block Center for further information at 1-877-41-BLOCK.