Sleep problems may increase risk for prostate cancer

Men who reported sleep problems, including difficulty falling asleep and staying asleep, had up to a twofold increased risk for prostate cancer, according to recently published data.

"Sleep problems are very common in modern society and can have adverse health consequences," said Lara G. Sigurdardóttir, MD, at the University of Iceland in Reykjavik. "Women with sleep disruption have consistently been reported to be at an increased risk for breast cancer, but less is known about the potential role of sleep problems in prostate cancer."

Previous studies have generated conflicting results for an association between sleep disruption from working night shifts and the risk for prostate cancer. Sigurdardóttir and her colleagues, therefore, investigated the role of sleep in influencing prostate cancer risk. Their findings were published in Cancer Epidemiology, Biomarkers & Prevention (2013; doi: 10.1158/1055-9965.EPI-12-1227-T).

The researchers followed 2,102 men from the prospective Age, Gene/Environment Susceptibility-Reykjavik study, which involved an established, population-based cohort of 2,425 men aged 67 to 96 years. Upon enrollment into the study, the participants answered four questions about sleep disruption: whether they took medications to sleep, had trouble falling asleep, woke up during nights with difficulty going back to sleep, or woke up early in the morning with difficulty going back to sleep.

Among the participants, 8.7% and 5.7% reported severe and very severe sleep problems, respectively. None of the participants had prostate cancer at study entry. The researchers followed the participants for 5 years, and during this period, 6.4% were diagnosed with prostate cancer.

After the researchers adjusted for age, they found that compared with men who reported no problems with sleeping, the risk for prostate cancer increased proportionately with reported severity of problems falling and staying asleep, from 1.6-fold to 2.1-fold. Further, the association was stronger for advanced prostate cancer than for overall prostate cancer, with more than a threefold increase in risk for advanced prostate cancer associated with "very severe" sleep problems.

To rule out the possibility that the problems with sleeping were because of undiagnosed prostate cancer or an enlarged prostate, the researchers reanalyzed the data after excluding men with symptoms of sleep disturbance that might be indicative of nocturia (waking up during the night to urinate). The results remained unchanged.

According to Sigurdardóttir, these data should be confirmed with a larger cohort with longer observation times. "Prostate cancer is one of the leading public health concerns for men and sleep problems are quite common," she said. "If our results are confirmed with further studies, sleep may become a potential target for intervention to reduce the risk for prostate cancer."
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